JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Registration form
Workshop Dates: 30, MArch 2023
Limited Seats: 20 participants only
Registration Fee: Before 31, March 2023
(Rs.500/- + 18% GST = Rs.590/-)
Contact details: Shridevi Gothe | Email :
dr.shridevi.g@tdu.edu.in
| Mob: 8951525526
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Title
*
Mr
Ms
Mrs
Dr
Full Name (in BLOCK letters)
*
Your answer
Email
*
Your answer
Contact number
*
Your answer
Organization/ Institute/ Company
*
Your answer
Location
*
Your answer
Qualification
Your answer
Designation
*
Your answer
Bank details
Beneficiary Name: UTD-HST General Fund
A/C No: 0694104000134705
IFSC Code: IBKLO000694
Bank: IDBI Bank, Yelahanka Branch
Fee payment through UPI (Google Pay/ PhonePe/ Paytm etc)
Mode of payment
*
NEFT/ RTGS
IMPS
UPI (Google Pay/ PhonePe/ Paytm etc)
Other:
Payment reference number
*
Your answer
Date of payment
*
MM
/
DD
/
YYYY
How did you hear about us?
TDU
Website
Directly recommended by a previous…
Whatsapp forward
Email forward
Option 6
Facebook
Twitter
Instagram
Recommended by ?
Others..
Clear selection
I declare that I have paid and register the workshop
*
Yes
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Education.
Report Abuse
Forms