21st FIMMDA - PDAI Annual Conference 2020
Venue: Hotel Hilton Diagonal Mars, Barcelona, Spain
REGISTRATION FORM (Please read the instruction before filling the registration form)

SEATS AVAILABLE - 225

DELEGATE COST

(Includes : Stay, Conference, all the events)
Early Bird Delegate COST :
Single Occupancy : Rs. 115,000 + GST @ 5.00% or as prevailing at the time of payment
TOTAL Amount : Rs. 1,20,750/-

Twin Occupancy : Rs. 100,000 + GST @ 5.00% or as prevailing at the time of payment
TOTAL Amount : Rs. 1,05,000/-

Non Members : Rs. 130,000 + GST @ 5% or as prevailing at the time of payment
TOTAL Amount : Rs. 1,36,500/

The Early Bird cost / price will be available till March 15, 2020 or the availability of seats in the package whichever is earlier. From March 16, 2020 the price will be : Single Occupancy – Rs. 136,500 (130,000+ GST 6500) and Twin -Rs. 120,750 (115000+ GST 5750) if seats are available


*Mandatory Field
Single Twin Single with spouse
Personal Details
Name as per passport *
(Surname) (Given Name)
Gender *
Name to be printed on identity Badge *
IF you are the spouse of a delegate please mention name of the delegate
Institution *
Designation *
Office Address *
Residential Address *
Meal Preferences * Vegetarian Non-Vegetarian
Email ID *
Phone No * +
(Country code - Mobile Number)
Emergency Contact Name *
Emergency Contact Number * +
(Country code - Mobile Number)
Personal Details
Name
Identity Badge
IF you are the spouse of a delegate please mention name of the delegate
Institution
Designation
Office Address
Residential Address
Meal Preference
Email Id
Phone Number
Emergency contact name
Emergency contact number
Identity
Date of birth
Passport Number
Passport Expiry(Minimum Validity 18-Feb-2020 or beyond)
Place of Issue
Issue Date
Payment
Payment Type
Cheque/Demand Draft No
Payment Date
Delegate Fees
GST(Rs)
Institution GST No
TDS
Net Amount
Remarks