 |
| |
Delegate / Media Pass Registration Form |
| |
|
Event Name |
: |
|
|
|
|
|
|
Venue |
: |
|
|
|
|
|
|
No. of delegates |
: |
|
|
|
|
|
|
Delegate Details |
: |
|
|
|
|
|
|
Salutation |
: |
|
|
|
|
|
|
First Name |
: |
|
|
|
|
|
|
Designation |
: |
|
|
|
|
|
|
Organization |
: |
|
|
|
|
|
|
Office Address |
: |
|
|
|
|
|
|
Postal Code |
: |
|
|
|
|
|
|
Country |
: |
|
|
|
|
|
|
Email |
: |
|
|
|
|
|
|
DID |
: |
|
|
|
|
|
|
Mobile |
: |
|
|
|
|
|
|
Fax |
: |
|
|
|
|
|
|
|
|
|
|
|
|
|
All particulars must be completed.
Registration will NOT be processed if
information is incomplete. |
|
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
The payment for the conference can be made as follows :
|
|
For Payments within India INR
|
|
Please make a cheque / DD in favour of Austral Asian Maritime Group payable at Mumbai & courier to-
604, Manish Chambers,
Sonawala Road,
Goregaon (East),
Mumbai 400 063
India
Tel: +91 22 4021 4305 |
|
Payments by bank transfer :
|
|
Payment by telegraphic transfer can be made to the following bank account.
|
Account number : 910020004356097 |
Account name : Austral Asian Maritime Group |
Bank Name: Axis Bank Ltd., Goregaon (East) Branch, Mumbai Swift (AXISINBB373)
|
Address: Manish Chambers, |
Sonawala Road, Goregaon (East), |
Mumbai 400 062, |
India. |
|
| |
| |
| |
| |