Ecumenical Christian Centre

GUEST - CONFERENCE REGISTRATION FORM

Download Application Form

01	Name of the Conference / Seminar / Workshop / Training
01	a. Conference Category	Residential Non-residential

Date of the Proposed Conference:

First Priority :

Second Priority :

03	Number of Participants and Composition	Nature	Indians	Foreigners	Total
		Resident Participants
		Non-Resident Participants

Objective of the Proposed Conference

05	Name of the Sponsoring / Coordinating Organisation
	a. Type of the Organisation:	Church NGO Company Government Others If Others (Specify)
	b. Please specify the name and address of the Co-sponsors, if the programme is jointly organised by two or more organisation / Institutions.
	01.	02.

Contribution towards reimbursement of costs of food and accommodation

Rs. a day for each member

07	Registration fee Rs. 1000/- to be sent along with registration form. (This Amount is non-refundable in case of cancellation or postponement.) Reservation will not be made available without registration fee.	Amount: Rs. 1000/- Cash Cheque Draft
		Cheque / DD No.
		Bank:
		Date:

08	Details of the Advance Payment: 50% of the estimated contribution (costs) must be remitted along with the registration form or at least 20 days in advance of your programme.	Advance Amount Rs. Cash Cheque Draft
		Cheque / DD No:
		Bank:
		Date:

10	Additional Requirements:
	(Please tick the specified column if you require any of the following items)
		TV / VCD / VCR (Rs. 450/- per day)	From	To
		PA System (Rs. 600/- per day)	From	To
		OHP / Screen (Rs. 400/- per day)	From	To
		LCD Projector (Rs. 2000/- per day)	From	To
		Computer (Rs. 600/- per day)	From	To
		Telephone connection without STD at Dialogue House (Rs. 300/- per day)	From	To

11	Name and Address of the Contact Person:
	Phone:	Fax:
	Mobile:	EMail:

12	Staff Welfare: Organisers are required to pay 5% of the total amount as contribution towards the Staff Welfare fund of the Center

13	Orientation: Conference organisers are required to assign 07 - 10 minutes on the first day of conference for a member of ECC Staff to introduce the center; it objectives and programmes. Please inidicate the scheduled time:

14	STD / ISD Facilities: At the Communication Centre on payment. STD / ISD / FAX / Broad Band Internet connection.

General Information:

a. Organisers canceling or postponing provisional reservation made will forfeit the registration fee.

b. Organisers canceling or postponing the confirmed reservation will forfeit the registration fee and 25% of the initial contribution towards total estimated costs.

c. Provisional reservations are made on receipt of registration form along with registration fee; Confirmed reservation is made on receipt of the initial contribution (advance payment).

d. If the participant is of foreign origin he / she is required to fill in the prescribed form furnished by the center.

e. For more details, please read the Service Directory of the center.

f. All the correspondence should be addressed to The Director, Ecumenical Christian Centre, Post Box. 11, Whitefield, Bangalore - 66

16	Mode of Payment: ECC accepts Cheque, Draft and Cash payment. The Cheque / Draft drawn in favour of ‘Ecumenical Christian Centre’ should be addressed to The Director, Ecumenical Christian Centre, Post Box. 11, Whitefield, Bangalore – 66 and be sent preferably by Registered post.

I / We agree upon the terms and general guidelines set by the Ecumenical Christian Centre for the use of the Centre's facilities for our programme.

Date:

Place:

Signature of the sponsoring /
Coordinating Organisation

Note: Original filled in Conference registration form should be sent to ECC and a copy of the same should be retained by the coordinating organisation for reference.


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