ENERTECH CONFERENCE DELEGATE REGISTRATION FORM
Delegates Rates (Per delegate)
1-2 Delegate: Rs.4500* or EURO 90* + 18% GST
3-4 Delegates: Rs.3500* or EURO 70* + 18% GST
5 or more Delegates: Rs.2500* or EURO 50* + 18% GST
For Student: Rs.1000* or EURO 20* (Including GST)

*18% GST applicable as per government rule
*The Delegate fees is 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.