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Program Title
 
 
Name 
 
Designation 
 
Organisation
 
Address
 
City  
Zip     
 
Telephone 
Fax 
 
Email          
     
   
We nominate the following persons from our organisation for the above workshop.
 
Name   
Phone
 
Designation
Email   
   
Attending At       
   
 
Name   
Phone
 
Designation
Email   
   
Attending At     
 
     
 
Name   
Phone
 
Designation
Email   
   
Attending At     
   
         
   Note :

This form can be used by individuals as well as company sponsored nominees.

All the payments need to be made through Cash/Cheque/Draft may be drawn in favour of Centre for Enhancing Human Performance , payable at Hyderabad.


 
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