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 Tuesday 29 Jun. 2010 Monday, 14 Jun. 2010 Wednesday 29 Sep. 2010 Tuesday, 14 Sep. 2010 Friday 29 Oct. 2010 Thursday, 14 Oct. 2010 Wednesday 29 Dec. 2010 Tuesday, 14 Dec. 2010 Monday 31 Jan. 2011 Monday, 17 Jan. 2011 Tuesday 29 Mar. 2011 Monday, 14 Mar. 2011   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