STARS Forum
Skills Training
Advancement in
Rural Societies
Annual Conference
December 3 & 4, 2012
REGISTRATION FORM
Name of the Person: _______________________________________________________________________________
Name of the Organization: __________________________________________________________________________
Address:
______________________________________________________________________________________
______________________________________________________________________________________
Phone: _______________________________________________________________________________________
Email: _____________________________
Website: ___________________________
Contact Person: ___________________________________________________________________________________
Name/s of person attending -
S. No.
|
Name of Attendee
|
Mobile No.
|
Please
Note:
Registration Fee: Rs.250/- per person.
Boarding: Breakfast and lunch will be
provided on both days of the conference.
Lodging: We have set aside hostel
rooms at Rs.125 per night. If you wish to stay here please check: ( )
Transportation: We will provide you
directions to the conference hall and hostel rooms. Please arrange
transportation on your own.
Assistance: STARS Forum has earmarked
limited budget to reimburse second class rail fare or bus travel, and to cover
lodging needs of those attendees whose organisations cannot meet their travel
expenses. If you would need to avail of this facility please check this box ( ) and we will contact you with further
details.
Contribution: We request and welcome your
organisation to be a contributing partner for the conference at any level.
Please indicate the level of your support Rs._______.
Thank you.
SIGNATURE......................................................
NAME.....................................................
DATE...................
