for National - University of Jerusalem

UNIVERSITY OF JERUSALEM
Post Box No. 26, No.237, Gospel Church Street, GST Road, Kadaperi,
West Tambaram, Chennai, Tamil Nadu - 600 045, India
Ph : +91-- 44 – 2238 3974, 3242 6288 Fax : 4204 0107 Cell : 0 - 9094949491
E--mail : [email protected]
WebSite : www.ujglobal.org
www.facebook.com/ujglobal
UJ’s 19th INTERNATIONAL CONVOCATION & ORDINATION REGISTRATION FORM
Date: Friday the 6th March, 2015 from 1:30 p.m. to 5:30 p.m.
Venue: APOSTOLIC CHRISTIAN ASSEMBLY (ACA Palavaram) Land Mark: Pallavaram Railway Station (Near Airport)
No.12-A,
A, Eswari Nagar, Pallavaram, Chennai - 600 043,Tamil Nadu, India.
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Name
Associate Number
Phone Number
Email Id
Fees Particulars
for Graduates /
Ordinates /
Honorary
Doctorates
Res:
Mob:
I am sending the following fees for myself (Please tick the relevant below)
Registration Fees - Rs.500/Gown
- Rs.200/Graduation Fees - Rs.300/- towards _______ Degree
Ordination Fees - Rs. ________
Honorary Doctorate Fees - Rs. _________ towards _______ Degree
6 Visitors
The no. of persons, who will accompany me : ________
I am sending herewith Rs.________as Offering.
I am sending herewith Rs. ________For Scholarship for needy
need Pastors.
Freewill Offering
I am sending herewith Rs. ________For Handicapped Ministry.
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I am sending herewith Rs. ________For Free Course Materials.
Mode of Payment: By M.O. No._____________
No._______________________ dated __________
By D.D.. No.____________
No._______________ dated _______________Bank_____________
____________________
Date: ………………………………………….
Signature:………………………………………………………………………………….
………………………………………………………………………………….
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Kindly Note: Travel and Accommodation expenses are to be borne by you and arrangements
have to be made by you. We will send the List of nearby Hotels to those who register. The
Conference Registration Fees, Graduation Fees, Ordination Fees, Honorary Doctorate Degree
Fees and Gown Fees are non-refundable.
refundable. If you have paid earlier, kindly produce the receipt
or inform the details of the payment at the Registration Counter in the Conference Venue.
Venue
If there is any change in your address,, which is pasted on this letter’s envelope, please
inform us your correct address.
---------Cut here, take
ake any number of Photocopies (Xerox) and pass them on to others-----University of Jerusalem, Post Box No. 26, No.237, Gospel Church Street, GST Road, Kadaperi,
West Tambaram, Chennai, Tamil Nadu - 600 045.
Cell : 0 – 9094949491 [email protected] www.ujglobal.org www.facebook.com/ujglobal
UJ’s Offer for New Enrolment
Special 19th Convocation Scholarship for Men and Women – (Until March 31, 2015
201 only)
Scholarship For those who pay Full Fees: Bachelor – 20% Master – 20%
% Doctorate – 20%
Scholarship For others: Bachelor – 10%
Master – 10%
Doctorate – 10%
-------------------------------------------------------------------------------------------------------------------------Please enroll me as your student and award me the special 19th Convocation Scholarship.
My Name: ………………………………
………………………………………………….….…….
Associate Number: ………………………
My Address: ……………………………………………………
…………………………………………………………..…………………………………………………………………….
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………….………………………………PinCode:……………
Phone Number:…………………… Cell:… …………………………………………………….
Email ID:
I wish to enroll in ………………….. Language: …………………
Date: …………………………
Signature: ………………………………………………
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