Registration form for IPCC/ ATC IT Training at Dombivli

Thane Branch of WIRC of

The Institute of Chartered Accountants of India [Set up under an Act of Parliament]

A-4, Laxmi Mahal, Nr. Hotel Parimala, Charai Naka Signal, LBS Marg, Thane(w)-400601,

Phone: 022-25382451/53/54, Email: thane@icai.org / Website: www.thane-icai.org

Undertaking: I hereby undertake to abide by all the Rules and Regulations of the IPCC/ATC IT Training of the

Institute of Chartered Accountants of India as may be in force from time to time during the period

I am undergoing training.

I am aware that in case of Cancellation NO REFUND will be granted to me.

I agree that in case need the admission Transfer/Cancellation will be the decision of Branch Management

Documents to be enclosed: 1. Demand Draft of Rs.4000/- in favour of “Information Technology Center – Dombivli, Thane Branch of ICAI”

payable at Thane

2. One Photograph to be affixed on the form.

3. Xerox copy of Registration letter and Acknowledgement receipt for IPCC

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Dombivli ITT Address

Shop 2, Aanandi Aanand CHS, Opp. Gulshan Juice Centre, Phadake Rd, Dombivli (E)

Register