<p> Indian Statistical Institute, SQC & OR Unit, Bangalore</p><p>Statistical Techniques for Business Analytics (BA-04) 25 - 27 May & 1 - 3 June 2017</p><p>Registration Form</p><p>Organization (Optional) : Contact Person : Mailing Address :</p><p>E-mail : Phone: Fax : Mobile: Details of the participants attending the program: Participant Name e-mail & Mobile Total Amount 1</p><p>2</p><p>3</p><p>4</p><p>A. Sub Total of above B. ADD: Service tax + Swachh Bharat Cess (15% of (A) ): C. Total Amount Payable (A+ B) :</p><p>Payment Details: Amount :Rs. DD/Transaction No.: Date:___/___/2017, Bank/Branch:</p><p>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.</p><p>Signature : Name: Date: :___/___/2017 ______Send completed form with fees and attachments to :</p><p>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</p><p>1. The course duration: 6 days : 25 - 27 May & 1 - 3 June 2017</p><p>2. 100% attendance is mandatory</p><p>3. Course fee per person: Rs. 32,775/- (Rs.28,500+ Service Tax of 15%) </p><p>4. Online fund transfer details</p><p> a. Name : Indian Statistical Institute</p><p> b. Bank : UCO Bank, Kengeri Branch, Mysore Road, Bangalore</p><p> c. Account No. : 02970200000702</p><p> d. IFSC code : UCBA0000297</p><p> e. Type of Account: Current Account</p><p>5. Income Tax Permanent A/c No. : AAAAI 0345 R</p><p>Service Tax Registration No. : S&T/B-III/Kengeri Dn./2/ISI/2001S.T.</p><p>Category : Scientific & Technical Consultancy Services</p><p>Service Tax RC Code : STC/AAAA I 0345RST003</p><p>6. No refund of course fee will be entertained after commencement of the program.</p><p>7. Participation is confirmed after receipt of</p><p> a. Filled in application form</p><p> b. Course fee in full (Cash, DD or online transfer)</p><p>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.</p><p>9. The participants who successfully complete the program will be issued the program completion certificate.</p><p>10. Any participant applied for the program is understood to have gone through and accepted these terms and conditions.</p><p>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].</p><p>Page 2 of 2</p>