Registrations

* Marked fields are mandatory to fill.

Registration Category : *

Title : *

Name (For Badge and Certificate) : *

Age (yrs)

Gender :

Address :

City / Town : *

State : *

Pin Code : *

Country : *

Email : *

Country Code : *

Mobile Number : *

Alternate Address

Alternate Email

Alternate Mobile

MCI Reg No

Would you like to join us for dinner on 1st November?

If yes, please specify the number of accompanying persons:
Please note: The per head plate cost would be ₹1500

Document

To upload the document follow these steps:
1. Click on the choose file / Browse button
2. If you're on your mobile you can take a picture and uplaod it or choose the photo from your gallery
3. If you're on your laptop/desktop choose the file saved in your system
Make sure the image you upload is not more than 3MB. PDF files are not accepted.

Bonafide Document : (Students bonafide certificate) (Mandatory)
PNG / JPG Image, Maximum 3 MB size

Age proof : (Senior citizens) (Mandatory)
PNG / JPG Image, Maximum 3 MB size

Total Paid Number of Accompanying person Added ( Age 5+):

Total Free Number of Accompanying child Added ( Below Age 5):

PAYMENT DETAILS

Total Amount Payable Rs. 0.00

Payment Mode :

Cheque/DD/Others details :

Payment Doc : (Screenshot / Copy)
PNG / JPG Image, Maximum 3 MB size