REGISTRATION FORM STATECON 2015 Real Estate Leadership Convention Friday, 30th January 2015 Hotel Atria, Palace Road, Bengaluru ORGANIZATION NAME & ADDRESS:______________________________________________________________ _____________________________________________________________________________________________ Delegate Details: 1) Name : __________________________________________Designation : __________________________________ Email : ____________________________________________Mobile : ______________________________________ 2) Name : __________________________________________Designation : __________________________________ Email : ____________________________________________Mobile : ______________________________________ 3) Name : __________________________________________Designation : __________________________________ Email : ____________________________________________Mobile : ______________________________________ 4) Name : __________________________________________Designation : __________________________________ Email : ____________________________________________Mobile : ______________________________________ 5) Name : __________________________________________Designation : __________________________________ Email : ____________________________________________Mobile : ______________________________________ Delegate Registration Charges: Rs. 1,124/- (Rs. 1,000 +ST.12.36% ) per head for Members Rs. 2,248/- (Rs. 2,000 +ST.12.36% ) per head for Non Members Cheque / DD for Delegate Registration should be in favour of CREDAI Bengaluru payable at Bengaluru. Details for Bank Transfers / NEFT Beneficiary Name: CREDAI Bengaluru Bank Name: UCO Bank Branch: Cantonment A/C No: 01510210000878 IFSC/NEFT Code: UCBA0000151 This Program is Non Residential President & Governing Body of CREDAI Karnataka & CREDAI Bengaluru Invites Participation of our Developer Members in large number to make this Event a Grand Success. For details refer brochure. Please ll up this form and send to Us. CREDAI Bengaluru: # 607-608, 6th Floor, Barton Centre, 84, MG Road, Bengaluru - 560 001 m: +91 99645 92255 t: +91-80-2559 1336 f: +91-80-3052 1481 e: [email protected] Organiser & Host