Gl slc 2011_Organizations Registration Form

PMI Pearl City Chapter, c/o CVM Solutions Pvt Ltd, 7-1-28/12/1, Serenity Plaza, Shyamkaran Road, Ameerpet, Hyd 500016

Contact – 040-40240178, 099898 45557 , Email – [email protected], [email protected] Website www.pmi-pcc.org

REGISTRATION FORM FOR ORGANIZATIONS / INDIVIDUALS

Here is an opportunity for your organization to participate in the GYAN LAHARI

Student Leadership Conference 2011 to be held at Shilpakala Vedika, Hyderabad

on February 3rd 2011. Don’t lose this wonderful opportunity. Please fill in the

Registration form and send it to PMIPCC to the following address. To expedite the

registration process, you may send the filled in registration form using e-mail as

well.

PMIPCC Postal Address

PMI Pearl City Chapter,

c/o CVM Solutions Pvt Ltd,

7-1-28/12/1, Serenity Plaza, Shyamkaran Road,

Ameerpet, Hyd 500016

e-mail

[email protected],

[email protected], [email protected]

Tele Phone Number + 91 40 40240178

Mobile Number + 91 99898 45557, 9949771197

GYAN LAHARI – STUDENT

LEADERSHIP CONFERENCE - 2011

“Ignite the minds of youth to build a developed nation”

mailto:[email protected]





Registration Form for Industry/Government/Others

INDIVIDUAL REGISTRATION

*Name of the Company (write in BLOCK

capitals only)

Name of the Delegate (BLOCK Capitals)

*E-mail id

*Telephone # (Mobile)

*Telephone # (Landline)

*Communication Address (Postal)

GROUP REGISTRATION FROM AN ORGANIZATION

*Name of the Company (write in BLOCK

Letters only)

*Organization’s E-mail id

*Organization’s Telephone # (Mobile)

*Organization’s Telephone # (Landline)

*Organization’s Communication Address

(Postal)

Number of delegates

(Please use additional sheet for more

number of registrations, name should be

in block capitals)

Either Organization OR Individual type registration is allowed

Conference Fees Details

CORPORATE / INDIVIDUAL PARTICIPANT



INDIVIDUAL /

CORPORATE

PARTICIPANT

GROUP OF 1-4 GROUP OF 5-9 GROUP OF 10 – 15

RATE PER PARTICIPANT `3000 `2500 `2000

PMI & PMIPCC MEMBERS

PMIPCC MEMBERS GROUP OF 1-8 GROUP OF 9-15 GROUP OF 16-25

RATE PER PARTICIPANT `2500 `2000 `1500

REGISTRATION FEES should be paid as a single Cheque / Demand Draft in favor of

PMI Pearl City Chapter (payable at Hyderabad) for all the participants.

(Please mention your/organization full name at the back of the Cheque / DD alongwith contact number

for us to contact in case of any discrepancies)

Please fill in the following details:

Cheque / DD

Number:

Bank:

Date: Amount:

We hereby confirm that the above mentioned details are correct to the best of our

knowledge and we also understand that PMIPCC has the right to reject the registrations if

any discrepancy is found in the information provided by the institutes:

Location: Signature & Name of the

Organization / Individual:

Gl slc 2011_Organizations Registration Form

Business

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