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RupeeTransmittalForm

Completetheformbelowandfollowinstructionsformailinginyour
payment.Thisformmustbemailedwithyourprintedorderform.
Member#:_____________________________
Date: _________________________________
Name: ________________________________
Phone:________________________________
Email: ________________________________

OrderTotal $US
(TheOrderTotalisonthePrintand
Mail/Faxform.)

RupeeConversionRate 55.50
RupeeAmountDue INR
(OrderTotalxConversionRate)

REMITTANCE
Cheque/DemandDraftto
MCIManagementIndiaPvtLtd
bemadeinfavourof:

Paymentmustbeinchequeordemanddraft.
1. Incaseofchequepayment,thechequemustbe"PayableatPar"in
allcitiesinIndia.
2. Thedemanddraftmustbemade"PayableatMumbai".
Sendpaymentto:
Mr.GauravSood
203,WingB,CityPoint
(NearHotelKohinoorContinental)
J.B.Nagar,AndheriKurlaRoad
Andheri(East)
Mumbai400059
India
Ifyouhavequestionsaboutthisprogram,pleasesendyourinquiryto
theIEEEContactCenter,www.ieee.org/contactcenter.
IEEE2014