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REGISTRATION
FILL UP FORM BELOW:
Fields marked with * are mandatory
Your Name
*
Your Email
*
Designation
*
Company
*
Phone No.
Mobile No.
*
Address
*
Number of Delegate
*
Amount
*
Mode of Payment
*
Select
Credit Card (master / Visa)
Cheque / Demand Draft
Fee is as follows:
One Delegate Rs. 6,000
5-10 Delegate 10% Discount
11-20 Delegate 15% Discount
21-50 Delegate 20% Discount
More than 50 Delegate 25% Discount
Cheque/DD to be sent in favour of “Adsert Web Solutions Pvt Ltd”
And send to
Ayushi Mukherjee
Adsert Web Solutions Pvt. Ltd. B-20, Sector 57 Noida (U.P) 201301 Ph: (0120) 4007700
Quote Your Name and Phone number on the back of the Cheque/DD
For any queries related to Registration, contact:
Ayushi Mukherjee:
ayushi.mukherjee@exchange4media.com
, +91 9716746064