..::FTD Infocom Pvt. Ltd.

Course Registration Form

Name *	:

Fees	:

Company Name	:

Address *	:
Course *	:

Contact Person	:

Telephone *	:

Fax	:

Email *	:

Total Fee	:

Administrative Details:

Fax (91-80-25506776) this form or e-mail or mail it together with the cheque made payable to
“FTD Infocom Pvt Ltd” you can also make the payment by VISA or Mastercard.

	Indicate the name of participant(s) and the course title on the reverse side of the cheque.

	No refund will be made for cancellation or non-attendance.

	For any enquiries, please contact 91-80-42600900.

	Confirmation of reservation only upon receipt of payment and on first come first serve basis.

	The training dates are subject to change with prior notice.

	All applicable taxes and customs to be paid by client.