REGISTRATION PROFORMA

Program for Exposure visit- Modern Water and Agriculture Technologies, Israel

June 4 -9, 2017

(TYPE IN BLOCK LETTERS PLEASE)

Name of the Mission Member

/ Designation
Name of the Organization:
Address:
Telephone (Landline):
Mobile: / Fax
Email / Website
Name of the Secretary / Mobile No. / E-mail ID
Annual Turn-over of the company
FICCI Member /Non-Member:
Company Profile
(Briefly mention in not more than 150 words about your company, products and services as well as any other point about your organization that you may like to highlight)
Specific Business Interests / Purpose of the Visit (not more than 50 words)
Personal Profile of the Mission member
(Briefly mention in not more than 50 words your educational & professional background as well as any other point you may like to highlight)
Travel Experience (Countries visited earlier)
Do you need Paper visa for Israel Yes No
PASSPORT DETAILS
Passport No. / Name as in Passport / Date of Issue / Date of Expiry / Place of Issue / Date of Birth
ROOM REQUIREMENT
Single Double
Enclosures Checklist / Scan copy of the first and last page of passport
Photographs – Scan copy of your passport size coloured photograph
Cheque/Demand Draft towards delegation Fee drawn in favour of “Federation of Indian Chambers of Commerce and Industry”, payable at New Delhi
Delegate Fee / Rupees 45,000 (Rupees Forty Thousand) per delegate + 15% Service tax
Cheque / DD No. ______dated ______in favour of ‘Federation of Indian Chambers of Commerce and Industry’ payable at New Delhi
Terms and Conditions:-
  • Please note that this delegation fees is charged for organizational expenses such as booking of venues for the seminars and B2B Meetings.
  • The delegates have to bear the expenses of flight bookings and accommodation on their own.
  • We will be nominating a travel agent however the delegates are free to book their flights and accommodation on their own as per the scheduled itinerary. It is advisable to book the same hotel in which the delegation is staying for coordination of meetings and field visits.
  • Delegates not wanting to stamp Israel visa on passport, may apply for separate Indian passport for travel to Israel (validity of 1 year). Israel Embassy in India no longer issues paper visas (visa not stamped on passport) and the only other option where Israel visa may not be stamped on passport is a Group Paper Visa. However there are restrictions whereby the group (min 10 persons) has to travel together (arrive and depart Israel at the same time frame). FICCI will facilitate application of Group Paper Visa (at cost).
  • Please note delegation fee will not be refunded, in case the delegate does not travel for this delegation.

Cancelletion policy / In case of cancellationprior to 20 days from the date of the event, there will be no refund of delegation fees.
Have you ever been arrested for/been charged with or convicted of any criminal offence in any country?
Please Note:Interested attendees should send this proforma along with delegation fess latest by May 5, 2017

(Note: Please use a separate sheet for related information you wish to include)

Place: Signature

Date:

Please return this proforma to:
Malvika Kareer, Assistant Director – Americas and Israel Division
FICCI,Federation House, Tansen Marg, New Delhi- 110 001
E: ;
T: +91-11-2348 7254 ; F: +91-11-2372 1504; M: +91 9873432301