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9th February, 2018Royal Orchid Bangalore

Name

Organization

Business Address

City

Direct Phone/ Mobile #

Fax

Nature of Business

Registration co-ordinator

Contact

Pin

Office Phone

Email

Designation

Email

Country

Designation

(Please use additional sheets in case of multiple delegates and fill complete details including mail id)

Seminar Fees:

For Company: Signature of authorised person:

Date:

Note: Payment should be made in favor of “Thoughtshows & Events Pvt. Ltd.”

Registration Type Delegate Fees

Particulars Nos. Rate Total Amount Payment Details ( Cheque/ Cash )

No. of Delegates

Mob: +91-09987961323 Email:rannu@vjmediaworks.com

1019/2 1st Main, 1st Cross, Geetanjali Layout, New Thippasandra, Bangalore -75. India

7

GSTIN: 29AACCT2398D1Z6

Individual Delegates Rs. 5000/- + GST Per Delegate

A N O A C I N I T I A T I V E TALKS H

P R E S E N T S

KARNATAKA

P O W E R E D B Y

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