Nomination Form

11th National Conference

“Safety & Health : Issues, Strategies & Programmes – Indian Situation - Global Vision”

5-7 April, 2006 at New Delhi

 Name & Address of Sponsoring Organisation
 

 

 

 

Tel :  

Fax :

E-mail :
Whether member of NSC? if yes write Membership No.:
Name(s) of the Delegate(s) and Designation
 
1.  
2.
3.
4.
5.
Payment is being sent by post/couries 

Amount Rs

·   Delegate fee should be drawn by “A/C Payee” Demand Draft/Cheque in favour of “National Safety Council”, payable at Mumbai.

·   Add bank clearance charges for outstation cheques as indicated in the Brochure.

Confirmation to be sent to :  Name & Designation