IIIrd ASEEM National Convention for Social Equity & Empowerment 2024

Email*

Name (in full)*

Mobile Number*

Gender*

MaleFemalePrefer not to sayOhter...

Professional qualifications*

Current designation (in office)*

District (Place of posting)*

State (Place of meeting)*

Permanent residence (if different from place of posting)

What is your motivation to join this meeting?*

Any suggestion to organizers for this meeting (write NA if you don't have any)!*

Please select your registration fee amount?*

--- Single - INR 2000 (UG Student - INR 1000)

--- Additional member - INR 1000 each

--- Family members below age of 15 yrs - Free

Single - INR 2000Family (2) INR - 3000Family (2+1) - INR 4000Family (2+2) - INR 5000UG Student - INR 1000Other

Use UPI QR code (UPI ID: babasahebaseem.96127283@hdfcbank) provided below to deposit the registration fees. After submitting the fee, take a screenshot or download the receipt. Upload it to the field given below.Please note that in case of any difficulty, please contact one of us: Dr Rajendra Jatolia (Mo: 9413974338) or Dr Mohan Bairwa (Mo: 9718835447).

Please submit any evidence of submission of the registration charges. (screenshot or PDF)*