Registration Form

To,
Amit Kaushal
Assistant Manager (Academy & Life Care)
TÜV Rheinland (India) Pvt. Ltd.
Plot # 328, Phase 4, Udyog Vihar,
Gurgaon - 122015, Haryana, India. / M: + 91 98119 83831
T : + 91 124 4422130 (B)/ 154 (D)
F : + 91 124 4422151

www.tuv.com/in

Certification Course on Six Sigma - Green Belt

Module1: 19, 20 & 21 Dec’16 Module 2: Jan’17 (2 Days)

(I)  Our organization will be represented by:

Sl. No / Name / Designation / Mobile No. & E-mail ID

(II)  Participation Fee: Rs…………………/- per participant + Service tax as applicable.

·  Early Bird Discount: 10% discount on delegate fee if registered with payment on / before 02nd December 2016

·  Group Discount: 10% discount on 3 or more people from single organization

(III)  Please tick [ P ] whichever applicable

¨  The delegate(s) fee of Rs...... vide cheque at par / DD No / online payment transaction ...... drawn in favor of TÜV Rheinland (India) Pvt. Ltd” payable at Bangalore is enclosed.

¨  Declaration

·  I / We understand the registration policy of TÜV Rheinland (India) Pvt. Ltd. that cancellations are not accepted, however substitutions are permitted

·  I / We hereby undertake that payment towards the participation fee from our side will be sent to TÜV Rheinland (India) Pvt. Ltd. latest by …………. upon the receipt of proforma invoice / original invoice / completing the vendor registration process. This is applicable even if any cancellation from our side due to any reasons

·  I have read and agree the general terms and conditions towards the registration

Nominating Authority:

Designation:

Company:

Address:

Tel: Fax: Email:

Signature:

*Signature is not essential while sending Registration Form by return e-mail to TÜV Rheinland (India) Pvt. Ltd.

General Terms and Conditions of TÜV Rheinland (India) Pvt. Ltd. on registration:

The above registration form constitutes a firm commitment to TÜV Rheinland (India) Pvt. Ltd. Cancellations of registrations / nomination(s) are not accepted. However, change of nomination(s) / substitutions at last minute is accepted. Registrations are confirmed upon receipt of payment /declaration on payment. Pre-registration and prepayment is essential for participation. Fee includes cost of certificate, course material, lunch & coffee / tea etc. Registration will be accepted on “First Come First Served” basis. This is a non-residential program. Delegate fee is non-refundable. Exact venue will be intimated by TÜV Rheinland (India) Pvt. Ltd. on receiving the confirmation from the participants.