INDIA CARPET EXPO

18th to 21st October, 2013

Sampurnanand Sanskrit University Ground, Varanasi

BUYERS REGISTRATION FORM

I / We wish to visit India Carpet Expo, 18-21 October, 2013 at Varanasi. I / We furnish our details for registration as under :-

1. DETAILS OF THE COMPANY : ( Please write in capital letters )

a. Company's Name ____________________________________________________ VAT No. ____________________________

b. Name & Designation of Representative (s) _____________________________________________________________________

c. Address ________________________________________________________________________________________________

City _______________________State __________________ Country___________________ Pin / Zip Code ________________

d. Phone: Country Code ________________ City Code________________ Number (s) __________________________________

e. Mobile: Country Code ________________ Number (s) ___________________________________________________________

f. Fax: Country Code __________________ City Code_______________ Number ______________________________________

g. *E-mail____________________________________________ Web-site ____________________________________________

2. Have you availed CEPC’s Complimentary package earlier. If so, please mention the year(s) :

i. Year: ____________, ii.: Year ____________ iii. Year: _____________ iv. Year: __________ v. Year:______________

3. OTHER INFORMATION : ( Please tick )

a. You are importing handmade carpets as: Retailer__Wholesaler ___Deptl. Store ___Chain Store __Speciality Store ____

b. Your items of import: Hand knotted Woollen Carpets _____ Silk / Art Silk Carpets ______ Handtufted Carpets ______

Handloom Carpets_____ Durries _____ Rugs _____ Others _____

c. Your sourcing country for import: India ___ China ____ Pakistan ____ Nepal___ Iran ____ Turkey ____ Others ____

d. *Your Annual Import of Handmade Carpets & other Floor Coverings for last 3 years ( in US $ )

Total Import: 2010 ____________________2011 _______________________2012_______________________

Import From India: 2010____________________2011________________________2012_______________________

e. *Details of outstanding payments in India – (i) for more than 6 months US $ __________________________

(ii) for more than one year US $___________________________

4. TRAVEL INFORMATION : ( Please tick)

a. Need Hotel Accommodation in Varanasi : Yes / No.

b. If yes, specify dates : Check-in _______________ Check-out _____________

I do hereby confirm that the above information furnished by me is correct to the best of my knowledge.

(*)Mandatory

Place ___________________ Signature__________________________________

Date ____________________ Name_____________________________________

Company's Seal ____________________________