REGISTRATION FORM – SIAM 3rd HR CONCLAVE

4th December 2015, Hotel Le Meridien, Pune

Organization Name: ______

Our organization will be represented by the following persons for the Conclave on 4thDecember 2015

Mr/ Ms/ Dr / Name (in capital letters) / Designation / E-mail / Will Also Join Mentoring Session # on 3rd December 2015 (YES/NO)

[Kindly use copies of this form for additional names]

# Kindly note that the Mentoring Session is complimentary for the conference attendees. However, seats are limited and would be

available on first come first serve

Contact Person
Designation
Address
Phone
Mobile
E-mail

Payment Details: Material offset charges *Rs 6000/- per delegate (Service Tax Extra)

Enclosed Cheque / Draft Date:

Drawn On: City:

Amount

All Cheque/ DD should be in favour of “Society of Indian Automobile Manufacturers” payable at New Delhi.

Includes SIAM Affiliate membership fee and service taxes.

Please send the form to Ms. Supriya Sinha, SIAM, Core 4B, 5th Floor

India Habitat Centre, Lodi Road, New Delhi – 110 003

(Tel: +91 11 24647810-12; Fax: +91 11 24648222); E-mail:

REGISTRATION FORM – MENTORING SESSION

3rd December 2015, Hotel Le Meridien, Pune

Organization Name: ______

Our organization will be represented by the following persons for the Mentoring Session on 3rdDecember 2015

Kindly note that the Mentoring Session is complimentary for the conference attendees. However, seats are limited and would be available on first come first serve basis. If you desire to attend only Mentoring Session on 3rd December, kindly use the form give below and send it along with the payment.

Mr/ Ms/ Dr / Name (in capital letters) / Designation / E-mail

Payment Details: Material offset charges *Rs 1500/- per delegate (Service Tax Extra)

Enclosed Cheque / Draft Date:

Drawn On: City:

Amount

All Cheque/ DD should be in favour of “Society of Indian Automobile Manufacturers” payable at New Delhi.

Includes SIAM Affiliate membership fee and service taxes.

Please send the form to Ms. Supriya Sinha, SIAM, Core 4B, 5th Floor

India Habitat Centre, Lodi Road, New Delhi – 110 003

(Tel: +91 11 24647810-12; Fax: +91 11 24648222); E-mail: