1.

Program Details
Program Name Train The Trainer
Date 21-22-23 August 2017
Timings 9.30 am to 5.30 pm
Location Pune
Investment Rs. 40000 + service tax as applicable
REGISTRATION FORM

2. Participant details
S. No. Name Designation E-mail ID Personal and Contact No.
(Printed on participation Official
certificate)
1.
2.
3.
4.

3. General information
Number of years of work experience in the current organization
Total Number of Years of work experience
Level of Management
Have you attended a Dale Carnegie Training program before?
(If yes, name the program and the year and location of attendance)

4. Address to be printed on the invoice

 Company
Name\Individ
ual
Billing Address
Industry
(E.g. – IT, Auto)
Contact Person Designation
Contact No. E-mail ID

5. Supervisor Details
Name - Designation -
Email id - Contact no. -

6. Registration Procedure
Form Submission Contact person: Ms. Situ Misra
Email ID situ_misra@dalecarnegieindia.com
Contact Number 020 6627 3615
 7. Mode of Payment
The payment can be made through Cheque/Demand Draf
Cheque/ Demand Draf
in favour of “Walchand PeopleFirst Ltd”
The bank details required for online payment
Vendor name: Walchand PeopleFirst Ltd.
Beneficiary account number: '03552790000133
Beneficiary bank name: HDFC Bank Ltd.
ECS Transfer Beneficiary bank IFSC code: HDFC0000355
Beneficiary bank address: Elphinstone House,
17, Murzban Road, Near CST, Mumbai - 400 001
Account type (Current/ Savings/ Any Other): Cash Credit
Email Id: vivek@walchandgroup.com
Dale Carnegie Training,
Walchand PeopleFirst Ltd,
Mailing Address of Payment 1, Construction House,
5, Walchand Hirachand Marg,
Ballard Estate, Mumbai - 400 001.

8. Terms and Conditions

a) Payment Policy We do not accept Cash or Credit Card payment
Participation will be confirmed on receipt of advance payment
The nomination(s) can be cancelled 7days in advance only.
b) Cancellation Policy For any cancellations afer this stipulated period of 7days no refund of fees will
be granted.
c) Intellectual Property Usage of any or all of the Trademarks and/or other Intellectual Property of
Policy Dale Carnegie Training India without prior written consent shall amount to
infringement. Participation or Completion of this program shall not entitle any
 participant to deliver or offer any Dale Carnegie Training Courses.

I agree with the above mentioned terms and conditions for registration:
Yes or No - _____