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Registration Form
A.Date Preference (Please tick any one):Any other exclusive date/s may be fixed for any organization with committed minimum 20 numbers of participants - Please call for more details
SLW(R)M Batch 4:
17-19 May 2018.
SWM Batch 1:
20-22 June 2018
B.Represantaion Form (Please tick Category)
State/NationalGovernment
City/District Administration
NGOs/Community Based Organizations
Donor
INGO
Others(Please Specify)
C.Name of the participant (IN CAPITAL)
*
D.Name of the Organization
*
E. Designation
*
F. Age
*
Gender
Male
Female
G. Education:
*
H. Mobile number
*
I. Email ID
*
J. Other contact number/s
*
K. Website:
*
L. Address for correspondence
*
M. Years of Experience & sector
*
N. Any other relevant information
O. Payment Details
Payment Mode
Bank Transfer
Cheque / DD
To be Paid Later
P. Travel plan (to be organized by the participant)
Arrival (Date & time)
Departure (Date & time)
Submit
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