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| DELEGATE REGISTRATION FORM | Save As PDF |
INTERNATIONAL LIGHTING WORKSHOP, LIGHTS IN GOA, 14-19 MARCH 2011, PANAJI, GOA INDIA
Register online at www.lightsingoa.com or complete this form in block capital letters and return by Fax or email to Workshop & Seminar Secretariat.
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One registration form per delegate
(Please fill up Workshop Conditions form and send along with remittance.)
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| Section A | DELEGATE INFORMATION |
| Title : * |
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| 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 : |
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| Please submit Association certificate membership number along with registration form |
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| Section B | REGISTRATION FEES |
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(Official document signed by the Dean/Program Director certifying Student Status must accompany Registration Form)
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| Section C |
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| Section D | METHODS OF PAYMENT |
| Payment should be made in Indian Rupees / US Dollars without charges for the beneficiary |
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| ALL INDIAN RUPEES TRANSACTIONS |
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DD in Favour of "IIID-LIGHTS IN GOA" payable at Panaji Goa India
Please send DD/Cheque details along with the registration form. |
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| 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 |
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| Important: Kindly fax a copy of the Telegraphic Transfer Confirmation form once the payment is made to +91-832-6644177 or +91-832-6643255 |
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| 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. |
| Section F | |
Workshop conditions for PLDA Workshop in Panaji, Goa/IND - 2011
(Workshop registration will not be complete untill this disclaimer is filled and mail on 'lightsingoa@gmail.com' )
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| TERMS & CONDITIONS |
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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) Fees include Day 1 - Lunch & Evening Meal, Day 2 to Day 4 - Lunch, Day 5-Friday Seminar, Lunch, Get-Together Party with Dinner; Maps & Jacket.
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CANCELLATION POLICY
A) Any Cancellation of Registration must be made in writing to the Seminar Secretariat, and only possible in case of Illness or unavoidable circumstances.
C) No Requests for refunds wiil be accepted after FEBRUARY 14 2011.
D) Refunds will be processed only after the Seminar, i.e. after 19 MARCH 2011.
E) Refunds will be affected with 30% deduction before FEBRUARY 14 2011, and with 50% Deduction after FEBRUARY 14 2011
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| Lights In Goa |
INTERNATIONAL LIGHTING WORKSHOP & 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: iiidgoa@gmail.com, lightsingoa@gmail.com
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