9Th South Asia CMVP Training & Examination

Awarded By In Conjunction with

. 12th South Asia CMVP Training & Examination 15 - 17 December, 2016, India Habitat Centre, New Delhi AEEE REGISTRATION FORM (Last Date for Registration: 5th December 2016)

Name ______Middle Name ______

Last name ______Date of Birth ______

Designation ______Company ______

Address ______

Mobile ______Е-mail ______

Personal E-mail ______

The DD/Cheque No. ______dated ______for Rs. ______towards Delegate Fee, drawn on Bank ______payable at New Delhi, is enclosed. (Online payment can be made to AEEE A/c No: 913010029778081; Axis Bank Ltd, Eros Corporate Tower, Nehru Place, New Delhi-110019; (IFSC Code: UTIB0000049, Swift Code: AXISINBB049). Please inform AEEE with complete transaction details if online payment is being made. Details of Participation Fees:

International Fee Category* Indian Participants Participants Training & Examination Fee 55,000 USD 1000 (Fee is for 3 days training workshop and certification exam)

Training (Alone) Fee 30,000 USD 750 Re-Exam Fee (within 2 years of initial Training & Exam) 25,000 USD 450 Note: Draft / Cheque in the name of “Alliance for an Energy Efficient Economy” 1. Advance Registration is essential. 2. Full payment should reach AEEE on or before 5 th Dec. 2016. 3. Registration/Confirmation will be as per norms of EVO & AEE, USA.

*10% Special discount for AEEE Member Companies and Individual Members *20% Special Discount for Women Candidate

In case candidate is sponsored by Company Name of the Authorized Person: ______Company : ______Address : ______Contact (Tel/ Mobile/E-mail) : ______Notes: - Separate Registration Form is required for multiple candidates - Only candidates who have registered & confirmed in advance will be admitted for the Training & Exam. Awarded By In Conjunction with

. Send your Completed Forms to: Mr. Bhairav Sharma [email protected] (+91-11-40567344), (M) +91-9811483702 Mr. Vaibhav Rai Khare [email protected] (M) +91-9873811852 Alliance for an Energy Efficient Economy, Saira Tower, 4th Floor, N-161A, Gulmohar Enclave, Yusuf Sarai, New Delhi, 110049 Tel: +91-11- 40567344