Date: 13th to 15th July 2018             Venue: School Campus, Ketti

 

The Alumni Relations Officer, LAIDLAW MEMORIAL SCHOOL of St. GEORGE'S HOMES, KETTI - 643215. NILGIRIS. INDIA
Telephone : +91-423-2517778

 
 
Full Name * Gender
Mobile Email *
Permanent Address *

 

City       State     Postal Code
Country
Years of Study: From   to           Classes Studied: From Std.  to   Std.
House Represented            Membership
Name of Spouse
 
Names of Children

 

No. of Persons / Items

Total

Georgians (till 5th July) ₨ 2500
Spouse and Children above 12 Yrs (till 5th July) ₨ 2500
Children 5-12 yrs. (till 5th July) ₨ 1000
Guests (till 5th July) ₨ 3500
2015 to 2018 Batches (till 5th July) *   ₨  500 *
T-Shirt Size Required Mention the sizes for no. of registrations 38 M     40 L   
42 XL   44 XXL
Total:
 
    Total

*Concession Fee for 2015 to 2018 batches does not include T-Shirt or Banquet Coupon. Please contact Alumni Relations Officer for concessional Banquet Coupon till 5th July 2018

Registration includes T-Shirt and Banquet

NEFT / RTGS / DRAFT / CHEQUE to be in the name of : OLD GEORGIAN ASSOCIATION Account Number 11290291324 - STATE BANK OF INDIA, Ketti Valley Branch, Branch Code. 7290 IFSC CODE SBIN0007290

Payment Details  Cheque No./DD.No./NEFT UTR /Cash No. *    Bank *     
Place 
   Dated *   (Outstation cheques Rs.100 extra)



 
    
   

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