REGISTRATION FORM

3rd Water Innovation Summit 2017Economic Growth & Human Development

in the context of Water Scarcity&

National Water Awards for Excellence in Water Management4 - 5 September 2017: Hotel Lalit, New Delhi

10% discount if there are more than three delegates. Prior registration and pre-payment is MUST for participation. Delegate fee is non-refundable; however change in nomination is acceptable. Please use extra sheet(s) for more nominations.

The following official(s) will attend the Conference from our organization as delegate(s):

S.No. Name Designation Company Name Email Mobile1

2

3

4

Our demand draft / cheque No. ____________ dated _______ for Rs. _________ drawn in favour of CII New Delhi is enclosed.

Name: ______________________________________________________________________________

Designation: _______________________ Organisation: ______________________________________

Address: ____________________________________________________________________________

Phone: _________________________________ Fax:___________________________________

Email: ______________________________________________________________________________

__________________________ For more details, contact:__________________________

Mr Vipin Varghese / Ms Preeti KathuriaConfederation of Indian Industry

CII - Triveni Water Institute Tel: 0124- 4234169/4309449/4014055

Email: Vipin.varghese@cii.in / Preeti.Kathuria@cii.in

A) REGISTRATION FOR DELEGATES

A) B) PARTICIPATION FEE DETAILS

C) WE WOULD LIKE TO EXHIBIT IN THE SUMMIT YES / NOIKE TO EXHIBIT

Category Delegates Fee GST (18%) Consolidate Delegate FeeCII Member 4000/- per delegate 720/- per delegate 4720/- per delegate

CII Non Member 4500/- per delegate 810/- per delegate 5310/- per delegate