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DELIGATE REGISTRATION FORM

Company Name :
Address :

PARTICIPANT DETAILS

Deligate Name Mobile No. Email

DELIGATE FEE

No. of Delegates: X ₹25,000
Trading Table: X ₹15,000=
Booth/Stall: X ₹30,000=
Grand Total ₹=

PAYMENT DETAILS

Amount: Rs. Cheque/DD no. Dated.
Bank Name: Branch:
RTGS/NEFT Details: Beneficiary:

Northern Seed Association

Bank A/c No : 914010015367603 ,
IFSC Code : UTIB0001889
Bank Name : AXIS Bank Ltd., Roshanara Road Delhi-110007
Date: Signatur & Seal