Elderly Couples Valentine's Day Sign-up Form 
Academy of Culinary Arts & Hospitality Management & Center for Leadership & Entrepreneurship College are organizing Valentine's Day at its premises for the elderly couple (age 70 & above) to share love and get blessing from elderly couple. There is no cost involved to participate. Please help us fill out this form to confirm your registration. Kindly note: Age requirement of 70 and above is apply to one of the partners either husband or wife, both does not have to be 70 cross. Example: Husband 71 year and wife 68 years are eligible.

Timing: 4:00 pm-7:30 pm
Attire: Cultural 
Venue: Academy of Culinary Arts & Hospitality Management, Lagankhel - Lalitpur, Kathmandu 
Contact Number: 9801298050

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Participant Name  (Husband) *
Age  *
Contact Number *
Participant Name (Wife) *
Age *
Contact Number *
Address *
Care Taker( If any)  *
Care Taker's Contact Number
 *
Care Taker's relationship 
 *
Your Food Preferences *
Your Food Restrictions if Any  *
Any additional information you would you like us to know? *
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