Nomination Form The One-Day Samsika® Brand Management Certificate Course Madam, The following representative of our company will attend the One-day Samsika® Brand Management Certificate Course® on: Tick approximate box   Day Course Date Last date for registration Friday 29 Jul. 2011 Thursday, 14 Jul. 2011 Tuesday 30 Aug. 2011 Tuesday, 16 Aug. 2011 Thursday 29 Sep. 2011 Thursday, 14 Sep. 2011 Friday 30 Dec. 2011 Wednesday, 14 Dec. 2011 Tuesday 31 Jan. 2012 Monday, 16 Jan. 2012 Thursday 29 Mar. 2012 Wednesday, 14 Mar. 2012   Name   Designation
Our Cheque/Demand Draft No
for Rs
Drawn in favour of Samsika Marketing Consultants Pvt Ltd is enclosed.
We have noted that the amount is non-refundable.
Name
Company Name
Address
Telephone No.
Fax
E-mail

Samsika^® Academy of Brand Management^®
Samsika Marketing Consultants Pvt. Ltd.
4117/8/9, Oberoi Garden Estates,
4th Floor 'C' Wing, Off Saki Vihar Road,
Andheri (E), Mumbai - 400 072.

Tel. No.: 022-28477700 / 28477701
Fax No.: 022-28477699