Two Day BOOT CAMP

On
Consensual Dispute Resolution

Organized by- In Partner with

Peacekeeping and Conflict
ADR CELL Resolution Team (PACT)

17th-18th September 2018

REGISTRATION FORM

Full Name [In Cap]

Dr./Mr./Ms/Mrs

Qualification

Company/Organization/School/College

Email:

Contact No: Mobile

Payment Details DD No. and Date:

NEFT Transaction ID:

ELECTRONIC CLEARING SERVICE (CREDIT CLEARANCE)/ REAL TIME

GROSS SETTLEMENT (RTGS) FACILITY FOR RECEIVING PAYMENTS

A. DETAILS OF ACCOUNT HOLDER

Name of Account Holder Centre for Developmental Education

Complete Contact Address Centre for Developmental Education

#8P & 9P KIADB Industrial Area
Electronics City 1st Phase, Bangalore-
560100
Telephone Number/Fax/Mail 9900067701

PAN AATC3674J

B. BANK ACCOUNT DETAILS

BANK NAME Axis Bank Ltd

BRANCH NAME WITH COMPLETE Electronics City,

ADDRESS, TELEPHONE NUMBER AND
EMAIL
#8P & 9P KIADB Industrial Area
Electronics City 1st Phase, Bangalore-
560100
IFSC CODE/NEFT CODE/RTGS UTIB0001541
CODE/BRANCH CODE

TYPE OF BANK ACCOUNT Corporate Banking/OD

 COMPLETE BANK ACCOUNT NUMBER 915030028994297

MICR CODE OF BANK 560211039

Note: A scanned copy of the filled in registration form needs to be sent to adrcell.ifim@gmail.com
on or before 9th September, 2018. Hard copy of the Demand Draft must be sent to college address.