Chemolympics 2023 Registration

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Google Forms <forms-receipts-noreply@google.com> Fri, 20 Oct 2023 at 3:40 pm

To: sureshpurbeyghy@gmail.com

Thanks for filling out Chemolympics 2023 Registration

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Chemolympics 2023 Registration

Please fill this form carefully. Only one response per candidate is allowed.
Registration fee (Rs. 100/-) to be paid online to A/C No. 10243129514. A/C Name: Society for
Chemical Education, Assam. IFSC: SBIN0002060. Please note the online transaction/receipt
number and date.
Compulsory: Please take a print-out of the filled form and submit to the respective Centre-
incharge before 30/10/2023 (5PM).

Your email (sureshpurbeyghy@gmail.com) was recorded when you submitted this form.

Name of Examination Centre *

Rangia College

Name of Candidate *

Ricky Purbey

Email *
 sureshpurbeyghy@gmail.com

Contact Number of Candidate *

8638858996

Name of the student's Institute/School/College *

Jawahar Navodaya vidyalaya,rangia

Class *

Online Payment Receipt/Transaction Number *

329384288099

Payment Date *

MM DD YYYY

10 / 20 / 2023

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