Registration Forms – E Plus Media

Registration Form

Event Details:

Dates: 30th & 31st January 2026

Venue: Novotel Hotel (Imagica) Khopoli, Maharashtra

Networking Gala Dinner: 31st January 2026 (included)

Residential Delegates:

Registration: FREE (Hotel stay charges apply)

Hotel: Novotel Hotel

| Room Type | Rate per Night (₹) | Inclusions |

Single Occupancy | 17,500 + GST | Accommodation, all meals, Networking Cocktail & Dinner (2 days) Double Occupancy | 20,000 + GST | Accommodation, all meals, Networking Cocktail & Dinner (2 days)

Booking Period: 15^th –17^th January 2026 (2 nights recommended)

Registration Type*

Residential Single Occupancy (₹17,500 + GST for 2 Days)Residential Double Occupancy (₹20,000 + GST for 2 Days)

Personal Information

Name*

Job Title*

Cooperative Bank Name*

Email Address*

Phone*

Address*

City*

State*

PIN Code*

For Residential Delegates (Additional):

Check-in Date

Check-out Date

Room Mate Name

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