VIRTUAL SUPRA SAEINDIA 2016
College Name:
Team Name:
1)......
2)......
3)......
4)......
5)......
Faculty advisor: ......
Faculty advisor signature: Captain Signature:
Please send the HARD COPY of this form to
Mr. Bibhu Kumar,
#1/17 Ceebros Arcade 2nd Floor 3rd Cross Kasturba Nagar AdyarChennai - 600 020
Mobile : +91 8870471510
And SOFT COPY of this form to:
TEAMDETAILS*Team Name
*Name of the Captain
*Contact Email Id.
*Phone No.
Department / Class
*Postal Address
COLLEGE / INSTITUTION DETAILS
*College Name
*Faculty Advisor
*Contact Email Id.
*Phone No.
Department & Designation
SAEINDIA ACTIVITIES
*SAEINDIA Collegiate Club details
*Date of SAEINDIA Collegiate Club formation
*SAEINDIA Collegiate Club Bank A/c Title Name.
*Bank Account Number
*Bank Name
*Bank Branch
*Bank Address
*Bank IFSC code
PAYMENT DETAILS
*Demand Draft/Cheque No.
*Demand Draft Date / DD in the Name of "SUPRA SAEINDIA".
Payable at Chennai
*DD Amount
*Issue-Bank Name/Place
Please send the HARD COPY of this form to
Mr. Bibhu Kumar,
#1/17 Ceebros Arcade 2nd Floor 3rd Cross Kasturba Nagar AdyarChennai - 600 020
Mobile : +91 8870471510
And SOFT COPY of this form to:
Extra Documents Required
HARD COPY OF THE FOLLOWING DOCUMENTS TO BE SENT TO
Mr. Bibhu Kumar,
#1/17 Ceebros Arcade 2nd Floor 3rd Cross Kasturba Nagar AdyarChennai - 600 020
Mobile: +91 8870471510
(No Soft copy is required of following Documents)
1. DD/Cheque of amount Rs. 17100 In Favour of “SUPRA SAEINDIA” Payable at Chennai.
2. A brief write up on college/University (One Page).
3. Resume of SAEINDIA Collegiate club activities since inception (One Page).
4. Write up on why you would like to participate (One Page).
5. An Undertaking, duly signed by your team leader, faculty advisor and head of the department with seal, that all the design and fabrication of your vehicle would be carried out inside your college premises and without and professional help (In case if you are found NOT complying to this, you shall be disqualified from the event with suitable notice)
NOTE:
1. No change is permitted in the team list of Virtual SUPRA.
2. All Participants attending Virtual SUPRA should have +1 SAEINDIA Membership and should carry the Membership Card during the event.
For Membership/Collegiate club Related Queries Please Contact:
Ms. Jean Sophiya Shiny
(044- 24411904, 42152280)
Last Date of Submission of all the Documents Both Soft and Hard copies is 20th August 2015 (Hard copies Should reach us by 20th Aug 2015)