Shri Mahavira Jaina Vidyalaya Education Foundation
C K Shah Vijapurwala Institute of Management
Vadodara
Registration Form
One Day Workshop On “Rural Marketing for Holistic Change & Development”
In collaboration with
International Institute for Holistic Research and Voluntary Action (India-Germany)
Rural Business Hub Foundation India
And
Federation of Gujarat Industries, Vadodara
9.30m to 4.30 pm, Friday, 24th September 2010 at C K Shah Vijapurwala Institute of Management, Vadodara
I / we shall attend the above workshop:
Sr
No
1
2
Name
Designation and Department /
Faculty
Mobile No
To defray the administration charges the Delegation fees is Rs 100/- per participant.
Our cheque / DD. _________________ for Rs. _________ dated ___________drawn in favor of
“C K Shah Vijapurwala Institute of Management, Vadodara” payable at Vadodara is attached.
Name: ________________________________ Designation: _______________________________
Institution / Organization: __________________________________________________________
Address: ________________________________________________________________________
________________________________________________________________________________
Tel: _____________________ Fax: ___________________________________________________
Email: ______________________________Mobile: ___________________________
THANK YOU!
Signature: ______________
Date: _________________
Note:
 Participation fee is non refundable, however change of Nomination is accepted
 Program is Non – Residential
 On the Spot Registration shall be accepted.