ACCOMPANYING PERSON REGISTRATION FORM (Fill in BLOCK Letters) Name of the Lead Participant : Date of Payment: Amount Paid: Mode of Payment: DD / NEFT Reference No.: Bank Name and Branch : Date of Online Registration: S. Name of the Accompanying Person Relation with the If IITG Hostel Gender Email No. Lead Participant Participating (Male / in in Female) “Nature Pixels” Required (Yes / No) (Yes / No) 1. 2. 3. 4. 5.
ACCOMPANYING PERSON REGISTRATION FORM (Fill in BLOCK Letters) Name of the Lead Participant : Date of Payment: Amount Paid: Mode of Payment: DD / NEFT Reference No.: Bank Name and Branch : Date of Online Registration: S. No. Name of the Accompanying Person Relation with the Lead Participant If Participating in “Nature in Pixels” (Yes / No) IITG Hostel Required (Yes / No) Gender (Male / Female) Email 1. 2. 3. 4. 5.
APRF.docx