Registration Form

Aerospectrum 2018
(“Gujarat: Air Quality Management Workshop for Industrial and Urban areas”)

(6th September 2018 at CEE Auditorium, Ahmedabad)

(Please fill up separate form for each participant)

Name of the participant(s).....................................................................……… Designation...................

Name of the Organization............................................................................................................................
Address............................................................................................................................................................
Phone(s): Office......................................................................Mobile............................................................
Email....................................................................Educational Qualification…...........................................

Fees per participant:

Rs.3500/- *(Rupees three thousand five hundred only)
Fees to be paid through Cheque/DD to be drawn in favor of “NFD CEE A/C IPP” or by NEFT/RTGS
to our bank account as per the details as under-
Name NFD CEE A/C IPP
Mobile No. +919879000544
Beneficiary Bank Name HDFC Bank
Bank Account Number 50100130580280
Beneficiary Bank Branch & Address OPP. Drive IN THEATRE BODAKDEV BRANCH
Ahmedabad-380054
Nature of Account Savings Account
RTGS/NEFT/IFSC Code HDFC0000049

Date: Signature of the participant

Important note:
Please send the scanned copies of duly filled in registration form and the cheque/DD (Rs
3500/-) through mail and the original DD/Cheque (or NEFT/RTGS details) and registration
form with details through post/courier to,

Mr. Vipul Patel Mr. Ketan Umralia,

APO, Environment Management Group, PO, Environment Management Group,
Centre for Environment Education Centre for Environment Education
Thaltej Tekra, Ahmedabad – 380054 OR Thaltej Tekra, Ahmedabad – 380054
E-mail:ketan.umaraliya@ceeindia.org
Tel: 079‐26844764, Mob: +919824754138
Tel.: 079‐26844821, Mob: 09409572007
Email: vipul.patel@ceeindia.org
Email: vipul.patel@ceeindia.org