international inner wheel conventiontransfer from jaipur railway station to hotel transfer from...
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rd thDate : 3 – 6 March, 2021Venue: Jaipur Exhibition and Convention Centre
INTERNATIONAL INNER WHEEL CONVENTION
www.iiwconvention2021jaipur.com
REGISTRATION FORM
Name Badge_________________________________________District _________________________________________________
Address ____________________________________________________________________________________________________
Email Address for communication______________________________________________________________________________
Title___________ First Name ________________________________________ Last Name_________________________________
Telephone (+_______) ___________________________________ Mobile (+_______)____________________________________
City _____________________________________Country_____________________________________ Postcode______________
Inner Wheel Club of__________________________________________________________________________________________
PLEASE USE BLOCK LETTERS
Section 1 – Inner Wheel Member
Please select dietary requirements:
Vegetarian Non Vegetarian Non Vegetarian (Halal)
Other Medical Dietary requirements, if any______________________________________________________________________
Special Requirements: Please provide information about your specific needs (e.g. wheelchair access)
____________________________________________________________________________________________________________
Please select your delegate category:
Voting Delegate
I wish to serve as a Steward - Only for registered non-voting delegates, *stewards must speak fluent English
IIW Past President
Do you require simultaneous translation:
Do you require simultaneous translation headphones? Yes Language:_________________________ No
Please note: It is not guaranteed that simultaneous translation will be available. Cost and availability will be
shared at a later stage depending upon demand for each language..
Accompanying Person/s
First Accompanying Person:
Title___________ First Name ___________________________________ Last Name_______________________________________
Name Badge _________________________________________________
Please select dietary requirements:
Vegetarian Non Vegetarian Non Vegetarian (Halal)
Other Medical Dietary requirements, if any______________________________________________________________________
Special Requirements: Please provide information about your specific needs (e.g. wheelchair access)
____________________________________________________________________________________________________________
Second Accompanying Person
Name Badge _________________________________________________
Title___________ First Name ___________________________________ Last Name_______________________________________
Please select dietary requirements:
Vegetarian Non Vegetarian Non Vegetarian (Halal)
Other Medical Dietary requirements, if any______________________________________________________________________
Special Requirements: Please provide information about your specific needs (e.g. wheelchair access)
____________________________________________________________________________________________________________
All fees are quoted in Indian Rupee (INR) and are inclusive of GST
Early Bird RegistrationTill 31st October 2020
INR 35,000
INR 35,000
INR 35,000
Standard RegistrationFrom 1st November 2020
INR 40,000
INR 40,000
INR 40,000
Inner Wheel Member Registration
First Accompanying Registration
Second Accompanying Registration
On Spot RegistrationFrom 1st Feb 2021
INR 50,000
INR 50,000
INR 50,000
Registration Fee Total: INR______________________
Section 3 – Optional Social Functions
All fees are quoted in Indian Rupee (INR) and are inclusive of GST
Golf Day – Wednesday 3rd March 2021 INR 8,850
Please mention your handicap (1-40)________________________________________________________
Do you require a golf bag _________________________________________________________________
If yes, are you left handed or right handed
Left handed Right handed
Would you prefer a Steel Set or Graphite Set
Steel Set Graphite Set
Please indicate below if you will be attending the Group Discussion/ Workshop on Wednesday, 03 March
from 2:00 – 4:00pm
Yes, I will be attending No, I will not be attending
Section 2 – Social Functions
All social functions are inclusive with participant's registration; however, your indication of attendance is still necessary.
WELCOME RECEPTION – Wednesday 3rd March 2021 | JECC Lawns
Number Attending_________________________________
FRIENDSHIP DINNER – Thursday 4th March 2021 | City Palace
Number Attending_________________________________
GALA DINNER – Friday 5th March 2021 | JECC Lawns
Number Attending_________________________________
Total Payment Enclosed: INR____________________________________
See over for Payment Details
To assist us with your booking please complete the following details
Single Double Triple
Do you require an accessible room? _____________________________________________________________________________
I will be sharing with __________________________________________________________________________________________
Check - In Date: _________________________________________ Check - out Date: ______________________________________
Special Requests _____________________________________________________________________________________________
Accommodation Fee Total: INR__________________________________
All fees are quoted in Indian Rupee (INR) and are inclusive of GST
Crowne Plaza
Jaipur Marriott Hotel
Royal Orchid, Tonk Road
The Fern Ecotel Hotel
Pride Amber Vilas
Clarion Bella Casa
Sarovar Premiere
Hotel Marigold
Four Points by Sheraton
Grand Maple
Hotel Name
Five Star
Five Star
Five Star
Four Star
Four Star
Four Star
Four Star
Four Star
Four Star
Three Star
Category
0.1
9
8.5
8.6
2.9
8.9
12.9
0.8
10.6
1.5
Distance fromthe Venue (km)
Double Triple
12500++
8000++
7700++
7150++
8000++
7000++
6500++
7499++
7499++
4500++
14000++
9200++
8500++
7565++
8499++
8499++
5500++
Taxes
18%
18%
18%
12%
18%
12%
12%
12%
12%
12%
12500++
8000++
7700++
6600++
7500++
7000++
6500++
7499++
7000++
4500++
Single
Accommodation bookings are subject to availability. Total payment must be received with your registration to secure youraccommodation booking.
Section 4 - Accommodation
The Convention Secretariat has confirmed rooms in the selected hotels below for the benefit of Convention participants.The hotels have been selected due to their proximity to the Convention venue.
Please ensure you have read all the terms and conditions in the Registration Booklet prior to completing youraccommodation booking.
Section 5 - Transfers in Jaipur
Flight/ Train Number (Arrival) ______________________
Flight/ Train Number (Departure)___________________
Arrival Details ___________________________________ Departure Details ___________________________________
1000
1000
1000
1000
Transfer Details Amount (INR)
Section 6 - Summary of Payments
Section 1Section 3Section 4Section 5
Registration FeesOptional Social FunctionsAccommodationTransfer in Jaipur
INR___________________INR___________________INR___________________INR___________________
Transfer from Jaipur International Airport to Hotel
Transfer from Hotel to Jaipur International Airport
Transfer from Jaipur Railway Station to Hotel
Transfer from Hotel to Jaipur Railway Station
All payments must be made in Indian Rupee. Please select your preferred payment option below:
Method of Payment: Payment of registration fees must accompany all registrations. No registration will be confirmed until payment is received.Payment can be made by the following method:
Bank Transfer:
MCI GeTS India Pvt Ltd - IIW 2021Address: CITI Bank, DLF Square, M Block, Jacaranda Marg, DLF City, Phase II, Gurgaon - 122 002, IndiaIFSC Code: CITI0000014Swift Address No: CITIINBXAccount No: 0004889247
Please include your Full Name and attach the scan copy of MT100/Bank advice if paying through bank transfer and emailthe transfer receipt (remittance) to the Secretariat at [email protected].
I herewith confirm by my signature below that I have read and am fully aware and accept the cancellation/payment conditions and the liability/insurance conditions stipulated in the Registration Booklet and on the Convention Website: www.iiwconvention2021jaipur.com
Please keep a copy of this form for your records
Signature:__________________Date:__________________
Name - Please Print Clearly: ____________________________________________________________________________________