Registration - Fireside Panel 2018

JADAVPUR UNIVERSITY ALUMNI ASSOCIATION SINGAPORE (JUAAS)

Alumnus/Student of

Organization (if applicable)

Payment *

Pay now (Bank Transfer - Details on the right)

Pay at the Venue (Cash Only)

TO AVAIL OF SUBSIDIZED RATES

Students - Please carry your ID cards to be shown at the Venue

JU Alumni - Please clear your Annual Dues to avail the subsidized rates

Date of Booking *

PLEASE TRANSFER TOTAL AMOUNT TO THE FOLLOWING BANK ACCOUNT

NAME: JADAVPUR UNIVERSITY & NCE BENGAL ALUMNI ASSOCIATION

BANK: INDIAN BANK, SINGAPORE

ACCOUNT NO: 302438001

Name: *

Transaction Ref No. (Please write NA if paying at the venue) *

Email: *

Event Registration Form

Ticket Class *

Single Entry (S$ 20)

Couple Entry (S$ 40)

Non Member Entry (S$ 30)

No. of Tickets *

Total Amount *