GyanLahari - 2011 Registration Form for Organizations

1. GYAN LAHARI – STUDENT
LEADERSHIP CONFERENCE - 2011
“Ignite the minds of youth to build a developed nation”
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
Gyanlahari2011@pmi-pcc.org,
e-mail
office@pmi-pcc.org, support@pmi-pcc.org
Tele Phone Number + 91 40 40240178
Mobile Number + 91 99898 45557, 9949771197
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 – office@pmi-pcc.org, support@pmi-pcc.org Website www.pmi-pcc.org
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2. 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
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 – office@pmi-pcc.org, support@pmi-pcc.org Website www.pmi-pcc.org
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3. INDIVIDUAL / GROUP OF 1-4 GROUP OF 5-9 GROUP OF 10 – 15
CORPORATE
PARTICIPANT
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 Bank:
Number:
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:
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 – office@pmi-pcc.org, support@pmi-pcc.org Website www.pmi-pcc.org
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