One Day Seminar On

One Day Seminar on Board Diversity Saturday, 4th June, 2016 Hotel Le- Meridien, New Delhi

Theme: ‘Driving a Sustainable Organisation through Board Diversity’

Dear Sir/Madam, Please register the following person(s) as delegate(s) for attending ICSI - IOD Seminar on Board Diversity to be held on 4th June, 2016 in New Delhi.

Name of the Delegate: Mr. / Ms. ______Designation: ______Name of the Organization:______Address:______City ______State ______PIN______Membership No (If a member of Institute): FCS ______ACS ______Contact Details: Tel. Nos: Off.: ______Res. : ______Fax: ______E-mail:______Mobile: ______

FEE DETAILS Bank Draft / At Par Cheque bearing No. ______dated ______for Rs.2500 (Inclusive of service tax) favouring “The Institute of Company Secretaries of India” payable at New Delhi is attached. DD/Cheque should be sent along with the registration form to: Mr. Santosh Mathew Joint Director (Liaisoning) ICSI House, 22 Institutional Area Lodi Road, New Delhi- 110003 Tel No. 011-45341033

Amount transferred to Institute’s Bank Account through NEFT Mode on ______vide Transaction Number ______(please refer NEFT Mandate given below.)

Yours faithfully,

Date: Place: