Exhibitor Registration Form

Exhibiting Company's Name* GST NO.* Address* Mobile No* City* Email Id* Country* Website Date of Submission

Pin/Zip Code* PAN No. Name of PAN Holder Name for Stall Fascia* Select Exhibitors Member Of IIA*
Yes No No. of Stalls* Select Stall Size*

Products/Services to be displayed (Max 50 words)*

PAYMENT DETAILS

Payment of Rs Cheque/DD/Transaction No Transaction ID Cheque/Transaction Date

Payment Account Details:
Account Name: INDIAN INDUSTRIES ASSOCIATION
Bank: PNB, Vibhuti Khand, Lucknow
A/C No: 3926002105000804
IFSC: PUNB0392600 | Swift: PUNBINBBBPF
Contact: Mr. Abhishek Sharma (+91 93352 27167) or Ms. Aradhya (8601855543)