Automotive Electronics 2012 Delegate Registration Form
automotive.ycorpmedia.com
Please do not leave any applicable field blank Title ............. First Name:
Last Name:
Designation:
E-mail:
Organization: Address1: Address2: City - Pin Code:
Country:
Direct Tel.:
Fax:
Mobile:
Website:
I Will Participate in Following Events*: Dates
Conferences
Venue
Price (INR)*
Price (USD)*
AETS: In-Vehicle Infotainment & Telematics
19 -20 April 2012
Bangalore
17,000
350
AETS: Safety & Security
28 - 29 June 2012
Pune
17,000
350
AETS: Powertrain & Fuel Systems
8 - 9 August 2012
Chennai
17,000
350
Bangalore
17,000
350
AETS: In-Vehicle Networks
13 - 14 September 2012
AETS: Vehicle Diagnostics
8 - 9 November 2012
Chennai
17,000
350
13 - 14 December 2012
Gurgaon
17,000
350
81,600
1,700
Automotive Electronics Conference (AEC) 2012 ALL ACCESS PASS
SUPER SAVER GET
Group Packages No. of Delegates
Price per Delegate*
20
% OFF
Special Packages
Price per Delegate*
Exclusively for Academic Researchers & Students
INR 3,000
Per Event Basis
6 - 9 (@5% Discount)
INR 16,150 / USD 330
10 - 15 (@10% Discount)
INR 15,300 / USD 310
16 and above (@15% Discount)
INR 14,450 / USD 295
How to Register: ONLINE
FAX
PHONE
http://automotive.ycorpmedia.com
auto@ycorpmedia.com
+91 22 2765 4797
+91 22 2292 0453
Payment Information Registration forms must be accompanied by full payment in order to be processed. Payment should be made in the form of Cheque / Pay Order or Demand Draft (DD). Cheque / DD to be drawn in favour of ‘YCorpMedia’ payable at Mumbai. Please use Online registration for payment through Credit Card and Net Banking.
Payment Details* I/We are enclosing herewith the above payment through Cheque/DD No. ................................................................................................................. Drawn on (Bank Name)........................................................................... for Rs. ....................................................................................................... Additional Instructions Payment Information: Registration forms must be accompanied by full payment in order to be processed. Spelling error(s) on cheque and declined credit are considered non payments and registration will not take place. No registrations will be accepted over telephone. Cancellation Policy: Cancellations must be confirmed in writing. No refund will be made on cancellations. “No shows” are non-refundable and are liable for the full registration charges. If you cannot attend, you may send a substitute person. The orginal registrant must submit a written authorization for such a change. Confirmation: Please allow up to 10 days for mailed confirmation of your registration.
By sending in this registration form, I acknowledge that I commit myself to the immediate payment of the full conference fee. I have taken notice of all the terms & instructions on this form.
Name:
Signature: *Plus Taxes as applicable
Date: *Registration free includes the conference official documentation, lunch and social events.
Please Fax the completed form to +91-22-2765 4797 or mail to: auto@ycorpmedia.com