Booth Nos. : (Please list 3 locations in
order of preference-the first available
location will be confirmed)
1.
:
2.
:
3.
:
Total Cost :
(please refer to the enclosed layout plan
and booth rates for the location and cost
calculations)
Please enclose cheque / DD for 50% of above
amount payable at Delhi in favor of
Dentis0try Vision 2010
PAYMENT (This is in the case of Bank Transfer)
Reference/Transaction ID
Amount Transferred
Bank Transfer Details
PAYMENT (This is in the case of Cheque and D.D)
Delegates who want to register selves for the
conference, directly from their respective
place, shall follow the information provided
below.
Cheque/D.D No.
:
Date
:
Amount
:
Drawn on Bank
:
(Incase of Bank Transfer) Pay To Dentistry
Vision 2010
Account No
:
1565201003640
Bank
Details
:
Canara Bank, Pitampura, DentistryVision2010
Branch Code
:
1565
IFSC Code
:
CNRB0001565
Note :
Please Send a Copy of Bank Remittance Slip in
Case of Bank Transfer.
I/We Confirm that I/we have read the terms &
conditions and agree to abide by the same.
Desclaimer: By signing this form the
exhibitor agrees to indemnify DPFI from any
liabilities, claims, ets, that may exist due
to participation in the event
