REGISTRATION FORM

PEPSCON 2014

Aprial 4th

– 5th

, 2014

Hotel Taj Deccan, Banjara Hills, Hyderabad - 500034.

Delegate Fee

Delegates (PROFESSIONALS/PRACTISING ENGINEERS, etc.,) : Rs. 5,000/-

Members* (SEWC, IIA, ACCE, IAStructE, ICI, CREDAI) : Rs. 3,000/-

* Invited guests who could not confirm before 31st

March, 2014

REGISTRATION

Please register the following persons

Name Designation

1________________________________________________ ________________________

2________________________________________________ ________________________

Cheque / DD No: ____________________________DT ________________ for Rs___________________

(Rupees_________________________________________________) is enclosed towards Delegate Fee

Name of the

Organisation:________________________________Address:___________________________________

___________________________________________Phone:____________________________________

Fax:________________________Mobile:________________________Email:______________________

Cheque/DD should be in favour of “PRECAST CONCRETE ENGINEERS SOCIETY, HYDERABAD”

Name, Designation and Signature of the Authorised Person:

Organised by