Name of the Person, Designation and Address at which the Journal is to be mailed, write below
Name: ..........................................................................................................................................
Address: ......................................................................................................................................
......................................................................................................................................
......................................................................................................................................
State: .............................................................................................. Pin : ...................................
Phone: .............................................................. Mobile: ..............................................................
E-mail : .........................................................................................................................................
Please make payment by Bank Draft/Cheque (only local) payable sagar M.P. in favour of “Summer Internship Society”
Bank Draft /Cheque No................................................... dated ........................................................
Amount Rs. ................................................................... Drawn on ...................................................
Name of the subscriber ....................................................................................................................
Dated: ...................................................... Signature ......................................................................
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