All fields marked (*) are mandatory.
Name*
Designation*
Organisation*
Email*
Mobile No*
Number of Delegates
Cheque Details: Bank Name
   
Cheque Amount
  Cheque Number

Please note:

• The registration fee is Rs. 4000/- per delegate.

• All payments to be made via Cheque/DD, drawn in favour of 'Adsert Web Solutions Pvt Ltd.' payable at New Delhi

• All submissions to be addressed to 'Priyanka Sood' and send on the following address: B-20, Sector 57, NOIDA - 201 301, UP

• Discounts offered to delegates as per below:

   3 to 5 delegates- 10% discount
   5+ delegates- 20% discount

For queries on speaker slots contact : Pallavi Srivastava +91 9899882405  pallavi@pitchonnet.com
For queries on summit registration contact: Priyanka Sood +91 7838546600   priyanka.sood@exchange4media.com