Application form of company registration 

The Secretary
The Institute of Company Secretaries of India
‘ICSI House’ 22, Institutional Area
Lodi Road, New Delhi-110003 .
Dear Sir,
I/We request you to register me/us for imparting Training to the candidate sponsored by the Institute, in
accordance with the Company Secretaries Regulations, 1982 and the Guidelines for Training by Practising
Company Secretaries, 1985 as amended.
I/We hereby declare that l/we am/are in whole-time practice as a Company Secretary/firm of Company
Secretaries in practice subsequently l/we give below my/our necessary particulars for your consideration:
Name (In Block Letters) ____________________________________________
Membership Number ____________________________________________
Certificate of Practice No. and Date of issue ____________________________________________
Date, month and year from which in whole-time practice ____________________________________________
Office Address (in Block Letters) ____________________________________________
Appropriate office area (in measurement) ____________________________________________
If office is shared, please indicate details there of ____________________________________________
Telephone No. ____________________________________________
E-mail, if any ____________________________________________
Address for correspondence (in Block Letters) ____________________________________________
Broadly areas of Practice/Operations ____________________________________________
(i) No. of years in practice ____________________________________________
(ii) Working Hours ____________________________________________
(iii) Average annual gross income from practice ____________________________________________
No. of employees, other than the partner, if any,
and their position ____________________________________________
No. of trainees to be engaged at a time ____________________________________________
Amount of monthly stipend payable ____________________________________________
Particulars of other business/occupation engaged in,
if any ____________________________________________
(i) Nature of business/occupation ____________________________________________
(ii) Working Hours ____________________________________________
l/we undertake to remit Rs. 50/- towards the registration fee for a candidate while engaging him as an apprentice
and pay him stipend as fixed by the Institute from time to time.
Yours faithfully,
Signature Date : _____________