On-Line Form

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..................................EFT & LOA Workshop Participation Form.......................

On-Line Registration Form

We provide you with the easy payment options for your convenience.

Participation FEE Details

One Day Workshop : Rs 7200/- (160 USD) On-Line registration before the day of the workshop.
Two Day Workshop : Rs 12000/- (260 USD) On-Line registration before the day of the workshop.
Keynote Address : Rs 25000/- (Exclusively for corporate, institutions and groups for one and half hour session)

Procedure

Please fill the following On-Line Registration Form provided below for booking / registration for the upcoming workshop/seminar /keynote address and confirm your seats (Payment options are given below).
At any time during, after or between our talks you can reach us on our phone nos. or email ids for any clarifications.

Phone Nos : +91 9810329044, +91 9311956781.
Mail Id : smartemotions@gmail.com
Meet us at : 1597/28, Faridabad. HARYANA (INDIA).

(Between 11.00am - 4.00pm) (Prior confirmation is appreciated)

Bank details for Payment

Direct Bank Transfer. NEFT / RTGS (Bank transaction reference no. to be mailed/smsed)

If paid by cheque / DD. Pay to : SMART EMOTIONAL EXCELENCE.

A/C No. : 0857 0500 0520. Payable at : FARIDABAD

ICICI BANK. MICR CODE : 110229091, RTGS / NEFT / IFSC Code : ICIC0000857.

Branch : SECTOR-35, ASHOKA ENCLAVE, FARIDABAD

Subject to cheQUE realization.

On-Line Registration Form

*indicates required fields

*Name:

*Qualification:

*Occupation:

Any Alternate Therapy Qualification:

*Your city:

*Contact Nos.:

*Email Id:

*Date of Birth:

*Preferable Language of Course Material:

Purpose of Joining The Workshop:

*City of Workshop:

*Date of Workshop (dd-mm-yy):

*Single/Couple:

If couple, Name of Spouse:

Occupation of Spouse, If applicable:

*Amount:

*Payment Option Chosen:

Bank Ref. No./ Cheaque No:

In case of Cash Deposit, Bank & Branch Details:

*How do you come to know about the workshop:

If PERSONAL REFERENCE (Pls mention person'name):

Any other comment/remark/note:

PS :

Please check the details again, and if you want to make any ammendment, do it before clicking on SUBMIT button.
After verifying the details click on the SUBMIT button.

Declaration

"I hereby give my confirmation to attend the EFT & Law of Attraction workshop organised in the above selected city on the above selected date."

** In case of Payment through PAY PAL, We will send you the invoice first.

After filling the details click on the SUBMIT button.

Join The Micro Revolution

Smart Emotional Excelence presents
Exclusive EFT & Law of Attraction Workshop
"Have A Life, Not Just A Lifestyle"

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