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World U3A Conference

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					                             World U3A Conference 2010
           (Under the auspices of Indian Society of U3As & Mahatma Gandhi Gramodaya Vishwavidyalaya, Chitrakoot )
                                                   (Feb 8-10th,2010)

                                           REGISTRATION FORM

    1. Full Name (in block letters)
              Last name……………………….              First name…………………………
    2. Sex:                  Male [ ]   Female [ ]
    3. Corresponding Address:……………………………………………………………..
       ………………………………………………………………………………………
       Phone………………………. Fax…………………….E-mail…………………….

    4. Category:               Teacher    []      Student       []
                               [ ] NGO    []      U3A/member [ ] Any other…….
    5. Whether participating with spouse: Yes [ ]        No [ ]
    6. Are you contributing a paper:      Yes [ ]        No [ ]
        (b) Title of the paper………………………………………………….
    7. Do you need accommodation          Yes [ ]        No [ ]

    Registration fee: Payment details (a) Indian Participants:
       (i) ISU3A life member Rs 500… and with spouse…..                Rs 1000
       (ii) ISU3A non-member Rs 1000          and with spouse……’.      Rs 1500
                                         (b) Foreign Participants :    US $.100.......
                                              and with spouse only      US $ 150
      For Participants from SAARC countries: (i.e Bangladesh; Bhutan; India; Maldives;
       Nepal;Pakistan and Sri Lanka):The registration fee will be at par with Indian delegates
        Those registering before 31st December 2009, will have a 10% discount

Drafts / AT Par Cheques may be drawn in favour of “INDIAN SOCIETY OF U3As” payable at Udaipur
(Rajasthan )Or the amount may be remitted also by National Electronic Fund Transfer (NEFT) directly in
 ISU3A’ SBI a/c No 304 306 379 01 by quoting (a) Bank’s IFS Code number: SBIN0011406 by
INDIAN delegates and (b)SWIFT Code number SBININBB379 by FOREIGN delegates.
(Registration will facilitate free lodging (shared) ; fooding; local sight seeing in Chitrakoot and local transport)




                                                           Signature of the Participant

    All completed forms should be sent to                  Dr T M Dak, Secretary General ISU3A
                                                           Institute of Social Development
                                                           108A-Mahaveer Nagar, Sect4; Hiran Magri
                                                           Udaipur 313002, Rajasthan, India
                                                           Tel 91-9460822834 ; 91-294-2461579
                                                           Email isdu2001@yahoo.co.in


     For office use                Receipt No……………...........................Date……………………………….

				
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