COMMON REGISTRATION FORM

(Prospective trainees/participants can download this form & email it, duly filled in, to )

Date:

Name & Contact details: (of Individual trainee/EducationalInst/Corporate)

Name: Contact Address: Contact Tel no/s: Email id:

Month & year of training: City of training:

Training Program: (Please select the program(s) you wish to attend in bold)

SSYB - SSGB - SSBB - SSC - Lean Mgt - Other Business Excellence programs

(Note – SSBB, SSC, Lean Mgmt & some other Business Excellence programs are not offered under Educationalworkshop).

Type of Workshop: (Please select the applicable workshop in bold)

Public workshop Educational workshop Corporate workshop (for individuals) (for student group) (for sponsored group)

Brief Academic & Work profile of the trainee(s):

Academic discipline pursuing (students) / pursued (working/self-e mployed professionals) / Designation (mention student if studying & job position / Dept, if working or Own business/self-employed) / Organisation name (Name of Educational institution or Corporate or Own business)

Mode of Payment: Payments are accepted by DD/Cheque/Online/Cash only.

(Select payment method in bold)

DD/Cheque no dated drawn on (Drawee Bank’s name) in favour of ‘Indian School of Professional Excellence’(please do not use the abbreviation ISPE while drawing cheque/DD) for Rupees (Amount in figures & words as per program chosen.)

(Trainee’s signature)

Note - Trainees can type their name abovein place of signature.

Instructions:

DDs/Cheques can be directly dropped in at any ATM centre or branch of Indian Bank, with which ISPE has a current a/c, after writing the payment details in the pay-in-slip (Please call ISPE at the below mentioned contact nos to get their bank’s Current a/c # ) available at the ATM centre/branch of the bank & attaching (pinning) it to the DD/Cheque. In case of making cash payment directly into the bank please call any of ISPE’s below contact nos for prior intimation.

Note – Fees once paid will not be refunded under any circumstances, except in cases where payment has been made by the trainee & cancellation done at least 10 days prior to the program. Substitute participant(s) is/are welcome, if the original participant(s)is/are unable to attend the respective training program for any reason(s).

Prospective trainees are requested to contact ISPE at the below mentioned details by phone or email for intimation of payment after making it by DD/Cheque/Cash at any of the Indian Bank’s ATM centre or branch directly. Please also feel free to contact ISPE for any other doubt(s) had / clarification(s) needed.

Indian School of Professional Excellence (ISPE) E-mail: Mobile: 91-9962271292 / 9176184091