For office use Received on: _________ Registration no: _______ TRAINING PROGRAMME ON BIOMEDICAL WASTE MANAGEMENT FOR NURSES Kerala Sate Pollution Control Board, Pattom, Thiruvananthapuram, 695004 19th September 2002 At Mannapuram Hotel, Kuruppam Road, Thrissur, 680 001. REGISTRATION FORM 1. Name of participant : 2. Designation : 3. Name of organisation : 4. Address for communication: a. Telephone office & residence : b. Fax number : c. E-mail : 5. Details of course fee remitted a. Amount : Rs. b. Demand draft number : c. Date : d. Bank : [Signature with seal of [Signature of participant] Nominating Authority]
