Delegate

Delegate Registration

Fields marked with * are mandatory

Name*

E-mail*

Mobile*

Designation*

Legal Name of the Organization *

Billing Address *

City*

State*

Country*

Pincode*

Delegate Pass Category*

Delegate Type*

Number of Delegate/ Tables*

Amount*

GST(18%)*

Total Amount (including GST)*

PAN No.*

Do you want invoice on your company name?*

Yes | No

Payment Mode*

FEES STRUCTURE:

Delegate Pass Booking

A.

Full Day Conference Pass: 4000* (Includes Lunch )
Awards Night Pass: Rs. 3500* (Includes Dinner and Cocktails)
All Access Pass : (Full Day Conference + Awards Night ): Rs. 6500* (Includes Lunch, Dinner and Cocktails)

B.

Table Booking
Full Day Conference (8 seats) | 25,000* (Includes Lunch)
For Awards (8 seats) | 23,000* (Dinner and Cocktails)
All Access Pass (8 seats) : (Full Day Conference + Awards Night ): Rs. 45000* (Includes Lunch, Dinner and Cocktails)

Note :
1. (*): Taxes as applicable.
2. All payments must be made at one go, either by credit/ debit cards, net-banking or cheque/ Demand Draft. (in favour of Adsert Web Solutions Private Limited and must be sent to 301, KakadBhavan, 3rd Floor, 11th Street, Opp. Galaxy Cinema, Bandra (W) Mumbai- 400(050) Tel: 022-66206000

Payment Instructions:

BANK NAME : HDFC Bank
Beneficiary Bank A/c No. : 50200044400435
A/c type : CURRENT
IFSC : HDFC0004398
Branch : Dwarka Sector-14, New Delhi-110075

4. No refund applicable on cancellation.
5. All submissions to be addressed to 'Amisha Shah

FOR ANY QUERIES, PLEASE CONTACT:

Prateek Goyal, : +91 9769124432 | prateek.goyal@exchange4media.com,