New Wave Display Services Pvt. Ltd.

28/7 Sahapur East, New Alipore, Kolkata 700 053

Phone: (91) (33) 2445 7235 / 7254
STEELMAN 2010
CGCRI AUDITORIUM KOLKATA OCTOBER 11, 2010
Fax: (91) (33) 2445 7254
E-mail: newwave@vsnl.com

DELEGATE REGISTRATION FORM FOR STUDENTS

Regn. No.
Dear Sir, (For office use only)

I/We wish to participate as delegate/s in the conference. My/our details are

as follows. Please tick
Veg Non-veg

Name & Designation :

Name & Designation :

Name & Designation :

Organisation :
Address :
Phone : Fax :
E-mail :

Registration Fees : For Student Delegate INR 1000/-

Registration Details
Registration Fees @ Rs. 1000/- per delegate delegates Rs.
Service Tax @ 10.3% Rs.
Total Rs.

Payment Details Account Details

Amount ____________________________________ Account Name : STEELRISE
A/c No. : 00402000014313
Cheq.No: ___________________________________
Bank : HDFC Bank Ltd.
Cheq.Dt: ___________________________________ Branch : New Alipore, Kolkata
SWIFT Code : HDFCINBBCAL
Bank ______________________________________

PLEASE RETAIN A COPY FOR YOUR RECORD