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Centre for Marketing in Emerging Economies
Workshop on The Power of Semiotics for Creating Value
May 29, 2015
Hotel Sea Princess
WORKSHOP REGISTRATION FORM
Please fill in ALL DETAILS ON BOTH PAGES of this registration form:
IIML Alumni
Students (Ph.D/Post graduate)
MRSI Members
Others
Full Name
Designation
Organization
Correspondence Address
City/ State
Country
ZIP/ PINCODE
Telephone (Mobile)
Telephone (Office)
Email Id
P. T. O.
CMEE, IIM LUCKNOW May 29, 2015 WORKSHOP REGISTRATION FORM
Page 1
Registration Details
Mode of Payment (tick
whichever appropriate)
Online
payment
Bank Draft
Wire
transfer
Others
Amount paid
If Bank Draft, specify
Name of
Bank
Draft
Number
If Wire Transfer, specify
Date of
transfer
UTR
number
If Online Transaction,
specify
Date of
payment
Transaction
ID
Any
other
specify details
means,
Date of Registration
Signature
In case of queries, reach us at:
cmee@iiml.ac.in
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CMEE, IIM LUCKNOW May 29, 2015 WORKSHOP REGISTRATION FORM
Page 2