BIO CONFERENCE DELEGATE REGISTRATION FORM
Delegates Fees
1-2 Delegates:2,500* or EURO 50* + 18% GST
3-4 Delegates :2,000* or EURO 40* + 18% GST
5 or more Delegates :1,500* or EURO 30* + 18% GST

*Per Delegate
*The Delegate fees inclusive of delegate kit, tea / coffee and lunch & it is non-refundable.
Please Choose Currency (Rs./EURO) :    Rs.: EURO:
Number of delegates:
 
DELEGATE NAME
DESIGNATION
COMPANY NAME
1
2
3
4
5
6
7
8
9
10

Organisation / Company name:
Address: City: Pincode:
State: Country: Tel:
Email: GST No: TAN No:
                      Kindly put NA if not have GST No/TAN No
Bank Details :
Remitting by way of T.T. may do so in favour of "Jasubhai Media Pvt. Ltd.",
Current A/c. 11037319604,
State Bank of India,
Churchgate Branch, Mumbai - 400 020, India.
Swift Code : SBININBB196.
Jasubhai Media Pvt. Ltd.