Seminar on

Financial Clinic for MSMEs

Facilitating Businesses for Sustainability
Delegate Registration Form
Day / Date Venue

Friday, 22nd April, 2016 Hotel Shangri-La, New Delhi

Delegate Fee*: 2,000/- per delegate (10% discount for two or more persons from the same
organization.) The Registration Fee includes Lunch, Tea/Snacks and Conference Material.
I / We would like to Participate in the Seminar.
Name of Organization:
Address:

Tel No: Fax No: Email :

Sr. Name Designation Mobile Email
No.
1.

2.

3.

4.

Payment Details:
Enclosed please find a Cheque/Demand Draft No. Dated
for drawn on in favor of “ASSOCHAM” payable at New Delhi
towards the registration fee for delegate(s).
*Registration Fee is non-refundable in any case

Online Payment Details (If Required)

Bank Name–State Bank of Hyderabad, 36, Zamrudpur, Kailash Colony, New Delhi – 110 048
*Change in the nomination is allowed

Beneficiary Name – The Associated Chambers of Commerce and Industry of India (ASSOCHAM)
Bank Current Account No - 52050210412 IFSC Code - SBHY0020588
*Program is non-residential

MICR Code - 110004007 Branch Code - 20588

You are requested to send the duly filled Registration Form along with payment by Courier, Fax or E-mail to:

Mr. U.K. Joshi

Director
The Associated Chambers of Commerce and Industry of India (ASSOCHAM)
5, Sardar Patel Marg, ChanakyaPuri, New Delhi – 110 021
Phone: 09811266345, 011-4655-0583 Fax: 011- 46550567
E-mail: u.k.joshi@assocham.com
Website: www.assocham.org