Dealers Booth application form

APPLICATION FORM FOR DEALER’S BOOTH

Name   :

Designation  :

Business Name :

Contact Address :

Telephone :

Email id :

Numbers of booths required :

Amount Rs10000/- remitted vide (Fill the appropriate) Enclosed Demand draft dated ............... drawn on ...................... (name of bank) in favour of  'The Kerapex-2016 Secretariat'                          OR NEFT transfer dated ................. to a/c No.522802010007188, IFSC Code: UBIN0552283 from ............... (name of bank)

I have read and understood the special rules of the exhibition and shall abide by them.

Signature:

Date:

Place: