<p> High Powered Business Delegation to Vicenzaoro - January 2015 </p><p>REGISTRATION PROFORMA</p><p>1. Name ______(Strictly as per Passport) 2. Designation ______</p><p>3. Organization______</p><p>4. Address ______</p><p>______</p><p>5. Phone: ______(Office) ______(Mobile)</p><p>6. Fax:______</p><p>7. Email: ______</p><p>8. Delegation Fee: INR 25,000 Only + Service tax @ 12.36% </p><p>The payment can be made by cheque/DD in favor of Federation of Indian Chambers of Commerce and Industry payable at Delhi</p><p>ChequeNo______Dated______Drawn on______</p><p>9. Company Write Up A .For administrative reasons and for preparing the delegate profiles, please attach your Company profile (not exceeding 100 words) (Please attach a separate sheet)</p><p>B. Nature and Type of business / industries you would like to visit and meet in Vicenzaro</p><p>Please send this completed form to </p><p>Ms. Surabhi Pant Assistant Director Federation of Indian Chambers of Commerce and Industry (FICCI), Krishnamai Building, Sir Pochkhanwala Road (Police Camp) Worli Mumbai 400030 022- 24968000; 91 9619119128; [email protected] </p>