DELEGATE REGISTRATION FORMSave As PDF
Register online at www.lightsingoa.com or complete this form in block capital letters and return by Fax or email to Workshop & Seminar Secretariat.
One registration form per delegate

Section A DELEGATE INFORMATION
Title : *
Mr : Ms : Ar : Dr :
Lastname : *
Firstname : *
Midddle-name : *
Profession : *
Organization/Institute : *
Position : *
Address : *
Pincode : *
City : *
State : *
Country : *
Mobile : *
Email : *
Phone :
Fax :
MEMBERSHIP NUMBER (PLDA/IIID) :
MEMBERSHIP NUMBER (PARTNER ASSOCIATIONS) :
Blood Group :
Please submit Association certificate membership number along with registration form
Section B REGISTRATION FEES
DELEGATE TYPEEARLY BIRDREGULARSPOT REGISTER
(TILL 31 DEC 2010)(BETWEEN 01 JAN2011 & 13 MAR 2011)
INDIAN RUPEES
REGULAR DELEGATE5000.00 5500.00 6000.00
DELEGATE (PARTNER MEMBER) 4500.00 5000.00 5500.00
DELEGATE (IIID / PLDA MEMBER) 4000.00 4500.00 5000.00
STUDENT DELEGATE 3000.00 3500.00 4000.00
(Official document signed by the Dean/Program Director certifying Student Status must accompany Registration Form)
INR USD
Section C
DIETARY PREFERENCE :   Vegeterian Others
Section D METHODS OF PAYMENT
Payment should be made in Indian Rupees / US Dollars without charges for the beneficiary
ALL INDIAN RUPEES TRANSACTIONS
Demand Draft(Please add necessary Bank Charges)
Cheque(Please add Rs. 50 for Bank Charges)
DD in Favour of "IIID-LIGHTS IN GOA" payable at Panaji Goa India
ALL US DOLLARS TRANSACTIONS
TELEGRAPHIC TRANSFER
Account Name :IIID-LIGHTS IN GOA Account Number :03731450000030
Bank Name :HDFC BANK LTD Swift Code :HDFCINBB
Bank Telephone Number :+91-832-2464775 Fax Number :+91-832-2464711
Bank Address :EXCEL ELITE, CARANZALEM, GOA. 403 002 INDIA
Important: Kindly fax a copy of the Telegraphic Transfer Confirmation form once the payment is made to +91-832-6644177 or +91-832-6643255
Section E VISAS : Yes No
If you need a visa to enter India, please contact the Seminar Secretariat for an Official Invitation for your visa application.
This is not an Official Visa Application.
The purpose is only to inform the Seminar Secretariat.Please apply well in time for your Visa at the nearest Indian Embassy.
TERMS & CONDITIONS
REGISTRATION POLICY
A) All Registration forms with payment details must be sent to the Seminar Secretariat (one Form per Delegate) via courier or post.
B) Online Registration will be only for International Delegates.
C) A Confirmation Letter will be sent to Registered Delegates via email or fax. Please carry this letter during registration at the Seminar Venue
D) An Official receipt will be sent to all registered Delegates upon receipt of complete payment.
E) All Delegate fees are in US Dollars or Indian Rupees inclusive of prevailing VAT/Taxes.
F) Delegate Registration Fees would cover the cost of Lunch and tea/coffee on all Seminar Sessions days as well as the Gala Dinner on the last day.
CANCELLATION POLICY
A) Any Cancellation of Registration must be made in writing to the Seminar Secretariat.
B) Replacement of Delegates will be accepted at no extra charge provided a written request is submitted to the Seminar Secretariat.
C) No Requests for refunds wiil be accepted after FEBRUARY 14 2011.
D) Refunds will be processed only after the Seminar, i.e. after 18 MARCH 2011.
E) Refunds will be affected with 30% deduction before FEBRUARY 14 2011, and with 50% Deduction after FEBRUARY 14 2011
Lights In Goa

INTERNATIONAL LIGHTING SEMINAR - SECRETARIAT

IIID-GOA REGIONAL CENTRE
T-9, BLOCK A, CAMPAL TRADE CENTRE, DR B PEREIRA ROAD, OPP VIVANTA BY TAJ, CAMPAL
PANAJI 403001 GOA INDIA
TEL: +91-832-2234477
FAX: +91-832-6644177
EMAIL: