Automotive Component Manufacturers Association of India

3rd Summit of ACMA Centre for Technology (ACT) ‘ Digitizing Auto Component Industry in India- Creating SMART FACTORIES’ Make in India Initiative 8th & 9th December 2017: Hotel JW Marriott, Senapati Bapat Road, Pune

Registration Form

Dear Sir / Ma’am,

1. Participation as delegates Company Name: ______

Plant Name/Location: ______

We are nominating the following personnel from our organization: (Either tick mark or fill color in appropria te box)

Member + Cluster company Non –Member Student

Sr. No. Name Designation E-mail ID Mobile No 1. 2. 3. 4. 5.

2. Fees for the two days of Summit The summit fee includes participation in summit, lunch & tea-coffee for both the days, dinner on first day, delegate kit and cultural program.

Per Delegate Fee * (Refer Discount Policy) ACMA Members + ACT / ACMA- Non-Members Students # UNIDO Cluster companies companies (Age: 17+ year) INR 4500 INR 5500 INR 1600 * GST will be levied # Students nominated by College based on their academic performance (max. 5 students per college, total seats for all college students are limited to 50) Discount Policy- for 10 & more number of delegates from one company, 20% discount on delegate fee (not applicable for students). Automotive Component Manufacturers Association of India

Please find enclosed our Local Cheque No: ______Dated: ______for INR______(Rupees______) Bank: ______Branch: ______in favor of “Automotive Component Manufacturers Association of India”, payable at New Delhi towards the delegate fee (s) for the ACT 3rd Summit, December 2017. Delegate Fee is Non-residential and Non-refundable and there is no restriction on the number of delegates per company.

In case of NEFT / RTGS:

Bank Name: Syndicate Bank; Bank Address: R.K.Puram Delhi Tamil Sangam Building, New Delhi- 110022; Bank Account Name: Automotive Component Manufacturers Association of India; Account Number: 90561010001497; IFSC Code: SYNB0009009; MICR Code: 110025043; Account Type: Current; ACMA GST No.: 07AAKCA3946Q1Z0

Form filled by & Invoice to be raised on: Name Designation Company GST Number Address as per GST registration UTR No.:(In case of NEFT/RTGS) TDS Deducted % (if any) Email ID Mobile / Telephone Number Invoice Address (with Pin code) Courier Address (with Pin code)

Please email the form to- Ms. Sakshi Karkamkar, Executive Officer, Email: [email protected],Mobile: 7387002181 OR Mr. Binny Tomy, Executive, Email: [email protected], Mobile: 9711138869

Mailing Address- Ms. Sakshi Karkamkar, Automotive Component Manufacturers Association of India {ACMA} Godrej Eternia-“C” building – ‘B’ Wing, Office No. - C , '10th Floor, Old Mumbai Pune Highway Wakdewadi, Shivaji Nagar Pune – 411005, India, Tel : +91-20-66061219 Extn :- 29 Website: www.digitalact.in, www.acma.in Email: [email protected]

Summit Venue Details- Hotel JW Marriott, Senapati Bapat Road, Pune – 411053, India. Tel: +91-20-6683 3333, 91-77 9898 3344

Enroll today for Mega Launch of Cluster Programs on 7th Dec 2017 at Hotel JW Marriott, Senapati Bapat Road, Pune – Digitization, Zero Defect Zero Effect (ZED), New Product Development & Design, Engineering Excellence, Advanced Lean, Operation Excellence and Resource Efficiency Programs