EARLY BIRD ACCREDITATIONS VALID TILL MARCH 30, 2014

General :

a) Single accreditation: Rs. 3,000 [Early Bird: Rs. 2,500]
b) Single accreditation with spouse: Rs. 5,000 [Early Bird: Rs. 4,000]
c) Group accreditation for individuals / organisations (five or more): Rs. 2,000 per person [Early Bird: Rs. 1,500]
d) Single accreditation for university / film school students: Rs. 1,500 [Early Bird: Rs. 1,000]
e) Group accreditation for university media course / film school students (five or more persons): Rs. 1,000 per person [Early Bird: Rs. 750]
(Reference name and mobile number of university / film school faculty member required for d and e.)

Press : Rs. 2,000 [Early Bird: Rs. 1,500]

For Uttarakhand residents / institutions / organisations:

a) Single accreditation: Rs. 2,000 [Early Bird: Rs. 1,500]
b) Single accreditation with spouse: Rs. 3,000 [Early Bird: Rs. 2,000]
c) Group accreditation for individuals / organisations (five or more persons): Rs. 1,500 per person [Early Bird: Rs. 1,000]
d) Single accreditation for university / film school students: Rs. 1,000 [Early Bird: Rs. 750]
e) Group accreditation for university media course / film school students (five or more persons): Rs. 750 per person [Early Bird: Rs. 500]
(Reference name and mobile number of university / film school faculty member required for d and e.)

For group accreditations, please contact neelima.mathur[at]gmail.com

Click here for single and with spouse accreditation form

DAILY RATE FOR UTTARAKHAND AND NON-UTTARAKHAND VISTORS: RS. 500 PER DAY

ONLINE ACCREDITATION FORM (Single and with spouse category):

EARLY BIRD ACCREDITATIONS VALID TILL MARCH 30, 2014

For group accreditations, please contact neelima.mathur[at]gmail.com

FIRST NAME :

MIDDLE NAME :

LAST NAME :

MOBILE 1 :

SPOUSE :

FIRST NAME :

MIDDLE NAME :

LAST NAME :

MOBILE 1 :

MOBILE 2 :

CONTACT ADDRESS :

CONTACT ADDRESS

EMERGENCY CONTACT NO :

PROFESSION + DESIGNATION :

NAME OF ORGANISATION / INSTITUTION IF ANY :

The above is mandatory for Press and single student accreditation

NAME OF FACULTY MEMBER (In case of students):

MOBILE NO. OF FACULTY MEMBER:

The above is mandatory for single student accreditation

Please upload your photograph in jpeg format and file size less than 1 MB.

For with spouse accreditations, please upload one photograph each of less than 1 MB.

CATEGORY OF ACCREDITATION : Please tick your option below.

Early Bird rates applicable till March 30, 2014

General :

a) Single accreditation: Rs. 3,000 [Early Bird: Rs. 2,500]

b) Single accreditation with spouse: Rs. 5,000 [Early Bird: Rs. 4,000]

d) Single accreditation for university media course / film school students: Rs. 1,500 [Early Bird: Rs. 1,000]

Press: Rs. 2,000 [Early Bird: Rs. 1,500]

For Uttarakhand residents / institutions / organisations:

a) Single accreditation: Rs. 2,000 [Early Bird: Rs. 1,500]

b) Single accreditation with spouse: Rs. 3,000 [Early Bird: Rs. 2,000]

d) Single accreditation for university / film school students: Rs. 1,000 [Early Bird: Rs. 750]

PAYMENT MODE :

( Please tick your option )

CHEQUE

FOR CHEQUES :

Cheque in the name of 'FOUNDATION FOR RESPONSIBLE MEDIA'

At the back of cheque, please write the following account details:

FOUNDATION FOR RESPONSIBLE MEDIA

ACCOUNT NO : 000310 0023 7779

Please provide details below and deposit cheque it in the nearest HDFC bank in your city.

Cheque no:

Date :

Amount :

FOR BANK TRANSFERS :

Routing via :

Foundation for Responsible Media

Account Number :

000310 0023 7779

RTGS / NEFT IFSC Code : 

HDFC0000003

Bank Address :

G-3/4 Surya Kiran Building,19, K.G. Marg, New Delhi 110 001

Kindly intimate transaction details to neelima.mathur[at]gmail.com

PLEASE RE-CHECK YOUR FORM AND ENSURE ALL DETAILS ARE CORRECTLY FILLED IN.

YOU WILL RECEIVE AN EMAIL INTIMATION OF THIS FILLED FORM.

IF YOU STILL WISH YOU CAN PRINT NOW BEFORE PRESSING SUBMIT.