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AMITY NATIONAL MOOT COURT COMPETITION, 2019

(NOV 15TH-17TH, RAIPUR)

ORGANISED BY- AMITY LAW SCHOOL, AMITY UNIVERSITY


CHHATTISGARH

REGISTRATION FORM

NAME OF THE TEAM (INSTITUTION):

___________________________________________________________________________

EMAIL ID OF THE INSTITUTE/MOOT COURT COMMITTEE/MOOT COURT


SOCIETY:

___________________________________________________________________________

DETAILS OF THE ORGANISATION/INSTITUTION (ADDRESS & CONTACT


DETAILS):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

PARTICIPANT’S DETAIL:

SPEAKER 1

NAME: __________________________________________________________________
COURSE: ________________________________________________________________
YEAR/SEMESTER: _______________________________________________________
CONTACT DETAILS: _____________________________________________________
EMAIL ID: _______________________________________________________________
SIGNATURE OF PARTICIPANT: ___________________________________________
SPEAKER 2

NAME: __________________________________________________________________
COURSE: ________________________________________________________________
YEAR/SEMESTER: _______________________________________________________
CONTACT DETAILS: _____________________________________________________
EMAIL ID: _______________________________________________________________
SIGNATURE OF PARTICIPANT: ___________________________________________

RESEARCHER

NAME: __________________________________________________________________
COURSE: ________________________________________________________________
YEAR/SEMESTER: _______________________________________________________
CONTACT DETAILS: _____________________________________________________
EMAIL ID: _______________________________________________________________
SIGNATURE OF PARTICIPANT: ___________________________________________
PAYMENT OF REGISTRATION FEE:

THE REGISTRATION FEE IS INR 6000 (INCLUSIVE OF DINING AND


ACCOMMODATION) WHICH MUST BE PAID ONLINE BY THE TEAMS AS PER
THE DETAILS PROVIDED HEREINAFTER:

ACCOUNT HOLDER NAME: AMITY UNIVERSITY CHHATTISGARH


ACCOUNT NUMBER: 1186104000030250
BANK NAME: IDBI BANK LIMITED
BRANCH NAME: ADSENA, PS-KHARORA, RAIPUR
IFSC CODE: IBKL0001186

REGISTRATION FEE (AS PAID) DETAILS:


___________________________________________________________________________
ONLINE TRANSACTION NO./ID:
___________________________________________________________________________
AMOUNT PAID:
___________________________________________________________________________
NAME OF THE BANK:
___________________________________________________________________________
DATE OF TRANSACTION:
___________________________________________________________________________

SIGNATURE OF HOI/HOD WITH SEAL

NOTE:

• THE REGISTRATION FORM DULY FILLED SHALL BE MAILED TO THE


MAIL ID ALSMCC.RPR@GMAIL.COM WITHIN THE STIPULATED TIME.
• ANY INCOMPLETE REGISTRATION FORM OR SENT ELSEWHERE
SHALL NOT BE ENTERTAINED.

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