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| PSG Tech 1979-84 Batch - 30th Yearly Reunion 2014 |
August 15-16-17th, 2014
at Isola Di Cocco, Ayurvedic Beach resort, poovar, near Trivandrum, Kerala |
| Registration Form |
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| Name in Full: |
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Payment
Details |
| Branch/Roll.
No. |
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Cheque / DD
No.: |
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Cheque / DD
Date: |
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| email id: |
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Drawn On Bank
/Branch: |
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| Phone No.: |
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Amount (Rs / $):Minimum
Rs.6000/- US$ 100 (* Pl see Note below) |
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| Mobile Number: |
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| Address for Correspondence |
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Sent On: |
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Sent By: Mail /
Courier/Other |
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Sent to whom: Sekar in India OR
Loganathan in USA |
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Cheques to favour: "PSG Tech 1979-84
Batch" (for non USA) |
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| Persons
Attending Reunion |
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* Note:
The base Participation fee is Rs.6000 / USD 100 per head.
The additional Participation fee is Rs.5000 / USD 100 per head.
However, all additional contributions to the 30th Year Reunion Fund are
welcome. The additional amounts will
be utilised to meet the full expenses of the Reunion as well as for the 79 BE
Batch to make a contribution to support worthy causes associated with the
College. |
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Name |
Age |
Sex (M/F) |
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| Self |
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| Spouse |
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| Child 1 |
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| Child 2 |
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| Child 3 |
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| Mailing Addresses |
Please fill this form and
Click "e-mail to: duraiswamyrajasekar@yahoo.co.in" at the bottom of this page. |
| In India: Make DD / Cheques
payable to "PSG Tech 1979-84 Batch" and send to: D R Sekar, "Kavya Fort",
78, East Lokamanya Road, R.S.Puram,
Coimbatore 641 002.
Phone:0422-2551633,2555634 Mobile: 94433 20750 |
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In the USA: Make the
cheque payable to "North American PSG Tech Alumni Association" and
send it to
Loganathan Palaniswamy, 3664, Cody Court, Santa Clara, CA
95051. Phone: 406-806-8330 |
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| Electronic Fund Transfer: If you have Internet Banking facility with electronic fund
transfer (NEFT) capability, you can transfer money directly |
| using the following details. Payee: PSG Tech 1979-84 Batch; Bank: Canara Bank; City: Coimbatore; Branch: R S Puram; A/c Number: |
| 1207101031975; A/c Type: Savings; Amount: 6000/-per head; (5000/-per additional head) Comment: "Your name-SJR" for identification. If your bank allows it, you can type |
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Number as: IFSC:CNRB0001207 1207101031975 |
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Use this space for any other information you would like to convey: |
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Username:
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