Details of the Participants Attending the Program

Indian Statistical Institute, SQC & OR Unit, Bangalore

Statistical Techniques for Business Analytics (BA-04) 25 - 27 May & 1 - 3 June 2017

Registration Form

Organization (Optional) : Contact Person : Mailing Address :

E-mail : Phone: Fax : Mobile: Details of the participants attending the program: Participant Name e-mail & Mobile Total Amount 1

A. Sub Total of above B. ADD: Service tax + Swachh Bharat Cess (15% of (A) ): C. Total Amount Payable (A+ B) :

Payment Details: Amount :Rs. DD/Transaction No.: Date:___/___/2017, Bank/Branch:

1. Registration forms will not be accepted without course fee. 2. No request for refund of the course fee (fully or partially) will be entertained after commencement of the program.

Signature : Name: Date: :___/___/2017 ______Send completed form with fees and attachments to :

Program Director: BA-04 SQC & OR Unit Indian Statistical Institute 8th Mile, Mysore Road Bangalore – 560 059, INDIA. E-mail: [email protected], [email protected] Page 1 of 2 Terms and Conditions

1. The course duration: 6 days : 25 - 27 May & 1 - 3 June 2017

2. 100% attendance is mandatory

3. Course fee per person: Rs. 32,775/- (Rs.28,500+ Service Tax of 15%)

4. Online fund transfer details

a. Name : Indian Statistical Institute

b. Bank : UCO Bank, Kengeri Branch, Mysore Road, Bangalore

c. Account No. : 02970200000702

d. IFSC code : UCBA0000297

e. Type of Account: Current Account

5. Income Tax Permanent A/c No. : AAAAI 0345 R

Service Tax Registration No. : S&T/B-III/Kengeri Dn./2/ISI/2001S.T.

Category : Scientific & Technical Consultancy Services

Service Tax RC Code : STC/AAAA I 0345RST003

6. No refund of course fee will be entertained after commencement of the program.

7. Participation is confirmed after receipt of

a. Filled in application form

b. Course fee in full (Cash, DD or online transfer)

8. ISI will provide a receipt for the payment received after the start of the course. The same to be used as a proof of payment. ISI accounting system does not entertain any other form of documentation.

9. The participants who successfully complete the program will be issued the program completion certificate.

10. Any participant applied for the program is understood to have gone through and accepted these terms and conditions.

11. Accommodation (a limited number) in twin-sharing basis can be availed as a first- come-first-served basis for the participants at the ISI guest house on extra payment basis. For accommodation in guest house, please contact [email protected] [AK Tiwari (+91 98454 84356)] after Enrolment and mark a copy of the request to [email protected].