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ICSI-WIRC JOINTLY WITH PUNE CHAPTER OF WIRC OF ICSI To, Mr. Anil Tale Assistant Director Pune Chapter of The ICSI 23, Mukund Nagar, Corner of Lane No. 1 Above Dr. Joshi Hospital Pune 411 037 To, Dr. S. K. Jena Regional Director WIRC of The ICSI 13, Jolly Maker Chambers No. 2 (First Floor), Nariman Point Mumbai 400 021 Dear Sir / Madam, Please register me for Full day program on KNOWLDEGE SKILL VISIBILITY to be held on September 12, 2015 at Hotel Aurora Towers, 9, Moledina Road, Camp, Next to West End Talkies, Pune, 411 001, Maharashtra. The following are my details: Name.................................................................................................................. Designation……………………………. Firm / Company Name.............................................................................................. Tel. Office…...................................... Res............................................................ Cell................................................ Fax............................................................... Email ID.............................................................................................................. Whether CSBF Member ...... (YES / NO) Membership No. ACS/ FCS ...................... / Students Registration No. ......................................... Fees: - ____________________________________________________ paid through cheque at Pune / Mumbai in favour of PUNE CHAPTER OF WIRC OF ICSI / WIRC OF ICSI. Signature.......................... NAME:

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Page 1: Registration Form

ICSI-WIRC JOINTLY WITH PUNE CHAPTER OF WIRC OF ICSI

To, Mr. Anil Tale Assistant Director Pune Chapter of The ICSI 23, Mukund Nagar, Corner of Lane No. 1 Above Dr. Joshi Hospital Pune 411 037

To, Dr. S. K. Jena Regional Director WIRC of The ICSI 13, Jolly Maker Chambers No. 2 (First Floor), Nariman Point Mumbai 400 021

Dear Sir / Madam, Please register me for Full day program on KNOWLDEGE SKILL VISIBILITY to be held on September 12, 2015 at Hotel Aurora Towers, 9, Moledina Road, Camp, Next to West End Talkies, Pune, 411 001, Maharashtra. The following are my details: Name.................................................................................................................. Designation……………………………. Firm / Company Name.............................................................................................. Tel. Office…...................................... Res............................................................ Cell................................................ Fax............................................................... Email ID.............................................................................................................. Whether CSBF Member ...... (YES / NO) Membership No. ACS/ FCS ...................... / Students Registration No. ......................................... Fees: - ____________________________________________________ paid through cheque at Pune / Mumbai in favour of PUNE CHAPTER OF WIRC OF ICSI / WIRC OF ICSI. Signature.......................... NAME:

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