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Delegate Registration Form

Name

Email

Mobile

Company/Institute Name and address :

REAI Life member:

Title of the Abstract/Speech with Ref. No.:

Details of Payment of Registration Fee: Paid Amount:

Mode of Payment:

UPI Payment Net Banking Card Payment

Date of Arrival

Date

Time (IST)

Bus/Flight/ Train No. and Arrival to Kochi:

Departure Date

Departure Time

Departure Bus/Air/ Train No. and Departure from Kochi:

Accommodation Required

Any Remarks