Registrations

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 8th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leadership Awards 2015

Wednesday, 30th  December, Hotel Hilton Mumbai International Airport, Mumbai, India

 “BRAND INDIA WINNING”

REGISTRATION FORM

I / we would like to attend / nominate the following:

Delegate 1 Delegate 2 Delegate 3
Name
Mobile:
Designation
Organisation
Address
City
Pin Code
Mobile:
Tel #
Fax #
Email
DELEGATE FEES Rs. 15,000 (Inclusive Service Tax) per delegate

10 % discount for Two or more members from same organisation.

METHOD OF PAYMENT DD / at Par Cheque / Cheque in favour of PHARMA LEADERS ACADEMY

payable at Mumbai

Bank Details :

Account Name PHARMA LEADERS ACADEMY. 093705000532
Bank & Branch Bank & Branch : Icici Bank, New Bel Road, Bangalore – 56 . Swift Code : ICICINBBCTS
RTGS/PAN NO RTGS/NEFT/IFSC CODE : ICIC0000937

PAN NO : AACTP2112L

  • Fee once paid is non – refundable, although change of nomination is allowed.
  • Cancellation of the nomination should be done 4 day in advance of the event. If advance intimation is not made for the same, registration fee is applicable and paid/ Bourne by the company or individual.
  • The registration fee includes lunch, refreshments.
  • Prior Registration is essential. Please fax/courier/email the registration form at the earliest.
  • Please see cancellation policy.