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Registration Form FACE 2003

 

Name                               :    -------------------------------------------------------------------------------

Designation                     :    --------------------------------------------------------------------------------

Address                           :    --------------------------------------------------------------------------------

                                             ---------------------------------------------------------------------------------

                                             ----------------------------------------------------------------------------------

                                             ---------------------------------------------------------------------------------

Email address                :    ----------------------------------------------------------------------------------

Phone No (STD code)    :    ------------------------------------------------------

Veg. or Non-Veg.           :    ------------------------------------------------------

Hands-on or Trainee Delegate    :    -------------------------------------------

 

Accommodation

Single or Double            :    -------------------------------------------

A/C or Non A/C             :    --------------------------------------------

Date    :    From    -----------------------------        To    --------------------------------------

Hotel Name                   :    ---------------------------------------------------------------------

 

Herewith enclosed a DD/cheque in favour of "FACE 2003" payable at Trichur. (Add Rs 50/- for outstation Cheque.)

DD/Cheque No            :    -------------------------------------------------------------------

Bank                            :    --------------------------------------------------------------------

Registration Fee                              :    -------------------------------------------

Advance Hotel Accommodation      :    -------------------------------------------

Total Amount                                   :    -------------------------------------------

 

 

Place:

Date:

Signature