1 st INTER NATIONAL MOOT COURT COMPETITION, 2017 ANSAL UNIVERSITY, SCHOOL OF LAW, GURGAON

R EGISTRATION F ORM

(TO BE FILLED IN BLOCK LETTERS)

Date: ____________

Name of the Institution: ___________________________________________________________________

Address:________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Person to be communicated regarding the competition:

Name: ____________________________________________________

Designation: _______________________________________________

Phone Number: _____________________________________________

E-Mail Address: ____________________________________________

1

TEAM DETAILS

1. Speaker 1:

Name: ____________________________________________________

Gender: __________________

Phone number: _______________________

E-Mail Address: ____________________________________________

2. Speaker 2:

Name: ____________________________________________________

Gender: ____________________

Phone number: _______________________

E-Mail Address: _____________________________________________

3. Researcher:

Name: ____________________________________________________

Gender: ____________________

Phone number: _______________________

E-Mail Address: __________________________________________

4. Demand draft* DD Number: ____________________________________ Issuing Bank: ___________________________________ Issuing Date: ____________________________________

*NOTE: GET A DEMAND DRAFT OF Rs. 3000, IN FAVOUR OF “ANSAL UNIVERSITY” AND SEND IT ALONG WITH THE ABOVE FORM.

Affix RecentPhotograph

Affix RecentPhotograph

Affix RecentPhotograph

Seal of the Institution

(SELF ATTESTED PHOTOGRAPH)

(SELF ATTESTED PHOTOGRAPH)

(SELF ATTESTED PHOTOGRAPH)