Register|Online

REGISTRATION FORM


Please fill all mandatory fields.

  Your Company Particulars:


Name *:

Company Name*:

Designation *:

Company Address*:

City*:

State*:

Country*

Pincode*:

E-mail*:

Phone Number*:

Office Tel. Number*:

Event Day 1:

Event Day 2:


  Billing Information:


Name *:

Company Name *:

Designation *:

Company Address *:

City*:

State*:

Country*:

Pincode *:

E-mail*:

Phone Number*:

Office Tel. Number*:

Event Day 1:

Event Day 2:

Company PAN No*:

Company GST No *:



Please indicate your choice by ticking the relevant boxes.

Registration Fees(per Delegate)

(Fees does not include accomodation and travel expenses.)
Full Convention costs 20000/- INR
One Day Convention costs 10000/-INR

ACADEMIA

Full Convention.
16th& 17th,Oct 2019
Any One Day Convention.
16th& 17th,Oct 2019
INR 15000/- +Taxes INR 7500/- +Taxes

INDUSTRY

Full Convention.
16th& 17th,Oct 2019
Any One Day Convention.
16th& 17th,Oct 2019
INR 20000/- +Taxes INR 10000/- +Taxes

STUDENTS

Full Convention.
16th& 17th,Oct 2019
Any One Day Convention.
16th& 17th,Oct 2019
INR 5000/- +Taxes

INDUSTRY

Full Convention.
16th& 17th,Oct 2019
Any One Day Convention.
16th& 17th,Oct 2019
INR 20000/- +Taxes INR 10000/- +Taxes

Discount applicable as per condition:

  • Below 10 Participants from same industry 25% Discount
  • 10 or above Participants from same industry 50% Discount


  Payment Method:



Cheque PayUmoney Neft
DD/Cheque No:*

Date:*

For Rs/$ :*

Draw On:*

In favor of 'Green ChemisTree Foundation',Payable at Mumbai India


  Payment Details:


Bank Transfer Details:
Name of Bank: State Bank Of India
Account Name:GREEN CHEMISTREE FOUNDATION
Account No:30932621346
Branch Code/Name:01975/Goregaon(E),Mumbai 400063
RTGS/NEF code: SBIN0001975
Swift Code:SBININBB518
Branch Address:Plot no:2,Jayprakash Nagar,Jayprakash Road No 2,Goregaon (East),Mumbai 400063,INDIA


  Tax Structure:



  • Please use additional forms for more number of delegates.
  • Please Complete the above form and mail to us at the following address.
  • Tel: +91-22-28791835/1275. Amardeep Gagat.
  • E-mail:- connect@industrialgreenchem.com
  • For Registration Visit us at: www.industrialgreenchem.com