Nomination Form

ITIL® Foundation for Service Management (ITIL® v3)

(A Three Day Workshop)

21 PDUs

Colombo: October 23 - 25 , 2008

The following form permits online submission. Please note that submission of this form is only a tentative registration for the seminar. The registration is not confirmed till payment is received.

You can alternatively print this form and fax it to QAI with details (fax no: +91-11-26218974).

Nominating Organization:*
Address:
City:*
Phone:*
Fax:
E-mail:*

Single Nomination: SLK 75,000* + 12.36% Service Tax
Task Force of Four: SLK 2,90,000* + 12.36% Service Tax

* Includes the Certification Exam Fee

S.No.	NAME	DESIGNATION	CITY

1.

2.

3.

4.

Total fees to be sent: Rs. *
Bank Draft/Cheque No.
Dated
Drawn on	payable at New Delhi in favour of "QAI (India) Ltd".
Your Name*
Designation

Timings: Registration: 9 AM, Programme: 9:30 AM - 6:00 PM

Cancellations received before 15 days of commencement of course will be entitled to a 50% refund. Please note all other cancellations are liable for the entire fee.

All cheques and nominations should be sent to the Delhi Office.