H.H. Swami Isa is the Founder of the Isa Viswa Prajnana Trust and the Global Energy Parliament. 
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Please print this page by going to "File...Print." Send completed form by e-mail or hard copy by 1st November to address below. (Note: Students' Parliament has separate registration form.) Global Energy Parliament Trivandrum, India 12-14th November, 2010
Name: __________________________________________________________________________ Designation: _____________________________________________________________________ Institution: ______________________________________________________________________ Address: ________________________________________________________________________ _______________________________________________________________________________ City: ___________________________________________________________________________ PIN: ___________________________________________________________________________ Country: ________________________________________________________________________ E-mail: _________________________________________________________________________ Phone (Residence): _______________________________________________________________ Mobile Phone: ___________________________________________________________________ Area(s) of Speciality: ______________________________________________________________ Sex: Male [ ] Female [ ] Comments: Payment Details Amount Rs: ............................. Transfer to account No. 67127248760, IFSC Bank Code: SBTR0000213 / SWIFT Code: SBTRINBBFED or Demand Draft in favour of "Global Energy Parliament" Amount Rs: ........................... Demand Draft No: ........................................ Date: ................................... Bank:.......................................................... Please send completed form and payment to: Secretary Global Energy Parliament 2010 c/o Isa Viswa Prajnana Trust Anayara P.O., Trivandrum 695-029 E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it Tel: +91 (0)471-2742533 Delegate Fees: Before 1 November, 2010: After 1 November, 2010: Indian: Rs. 2,000 Indian: Rs. 2,500 International: $150 International: $200
Students* (Indian): Rs. 500 Students* (Indian): Rs. 1,000 Students* (International): $45 Students* (International): $65 *Note: There is a separate registration form for the Students' Parliament. |
