invitationform

VEERAYATAN 3rd Global Convention Registration Form 24th, 25th, 26th January 2016 Please fill this form and mail to: veerayatanbihar@gmail.com Registration No. (For official Use Only)

Personal Information NAME:………………………………………………………………………………………………..

MAILING ADDRESS:…………………………………………………………………………….

CITY:…………………………………………………STATE……………………………………….

COUNTRY:…………………………………………………………………………………………..

MOBILE:……………………………………………………………………………………………..

TEL NO.:……………………………………………………………………………………………...

E-MAIL:……………………………………………………………………………………………….

Travel information:

Total number of people attending the event:

Male:

Female:

Children: (Below 12years)

Arrival: Date

From

Place of arrival

Time of Arrival

Flight /Train No.

By Road

Departure: Date

To

Time of departure

Please fill the above form and mail to veerayatanbihar@gmail.com or post it to the address below by 30th December 2015 Veerayatan Rajgir, Dist. Nalanda, Bihar, India. Pin -803116

Flight /Train No.

By Road

For transportation arrangements kindly contact Indian Tourist Bureau, Patna, Mr. Rajesh Kumar- 0943 101 6187 Mrs. Raja Priyanka -0983 501 1132/0977 149 2303 Email-indiantouristbureau@gmail.com

For any information please contact: Rajeev Ranjan - 0727–764–1515 Deepak Dwivedi- 0930–490–1202 Email - veerayatanbihar@gmail.com Note : Food and accommodation will be provided by Veerayatan

For official use Place of Accommodation …………………………………………………….…………

Block ……………………………………………………………………………..…………….

Male: Female: Children: (Below 12years)

Room No/Nos.:………………………………………………………………….……………