Registration for National Reform Summit 5-8 April 2013
Please complete all details below to register for the Summit. Payment make payment after completing this form, for a valid registration.
Name of main applicant *
(in full, including any titles e.g. Dr.)
Name of organisation
This is optional - in case you represent an organisation
Are any other persons expected to attend from your organisation?
This applies only if you represent an organisation, and more people are expected to attend from your organisation
Clear selection
If you answered "Yes" to the above question, please list the names of these other persons
Please provide full name/s of these additional persons, and also provide their contact phone numbers
Your phone number/s *
Please provide your mobile number and land line number
Your email address *
We will primarily use email to contact you. If you have two email addresses, please provide both of them.
Your address *
Please provide postal address in full. Important letters and documents may be sent to this address.
Do you broadly agree with the "Vision" published by SKC on its website? *
Although the vision will be further discussed and refined, it is important that you agree broadly with the vision before attending the Summit
Would you like to be treated as a sponsored participant of Patanjali Yogpeeth? *
Sponsored participants can pay only Rs.500 as registration contribution
Have you paid the relevant registration contribution? (Please do not pay if you disagree with the Vision) *
Please check the Brochure for details on registration charges and how to pay. Please do not pay registration charges unless you broadly agree with the Vision.
Any other comment/question
Please add a brief comment/question if you have any
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