Registration Form - Regional Delegates
*All fields marked with an asterisk (*) are mandatory and should be filled or checked
Indian delegates do not need to fill in the following fields: Passport Number, Passport Issue Date, Passport Expiry Date, Place of Issue
 Personal Information
Title* : Mrs Ms Mr Dr
Initials (if applicable) :
Last Name* :
First Name* :
Middle Name(s) :
Nationality* :
Passport Number* :
Passport Issue Date* :
(dd/mm/yyyy)
Passport Expiry Date* :
(dd/mm/yyyy)
Place of Issue* :
Occupation :
Organisation / School Name :
Work Address

:
City :
State :
Country :
Postal Code :
 Contact Information
Home Address* :
City* :
State :
Country* :
Postal Code* :
Home Phone*
(+country +area +no)		 : - -


Work Phone
(+country +area +no)		 : - -
Fax :
Mobile :
Email Address* :
Email Address (Alternate) :
Permission
I give my permission for my contact details to be distributed in a list to Congress participants.
Congress Registration Information
How did you come to know about the Congress? :
The sprawling 100-acre Kalakshetra campus, which is the venue for the Congress, includes a large formal auditorium and an informal theatre. The plenary sessions at the Congress will be held in the auditorium and will be screened simultaneously in the theatre. The delegates have the option of choosing to be seated in the auditorium or the theatre. The delegate fee will vary accordingly. The food and other facilities at the venue will be common to all delegates.
Auditorium INR. 7000/-
Theatre INR. 4000/-
What is your choice of seating?* : Auditorium Theatre
Visits to local schools are planned for the morning of Monday, January 5, 2009, prior to the official inauguration of the Congress. Transportation to/from the schools will be organised for the delegates. The cost of the school visit is INR. 400/-
Would you like to go on a school visit?* : Yes No
If you require accommodation please click on "continue to accommodation".
If you are arranging your own accommodation "skip accommodation".
Continue to Accommodation  || Skip Accommodation || Cancel