for International - University of Jerusalem

UNIVERSITY OF JERUSALEM
(British American Autonomous Body)
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
mail : [email protected]
WebSite : www.ujglobal.org
www.facebook.com/ujglobal
UJ’s 19th INTERNATIONAL CONVOCATION & ORDINATION REGISTRATION FORM
Date: Friday the 06th 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
6
Visitors
Freewill Offering
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Res:
Mob:
I am sending the following fees for myself (Please tick the relevant below)
Registration Fees - US $20
Gown
- US $10
Graduation Fees - US $10 towards________Degree
Ordination Fees - US $_________
Honorary Doctorate Fees- US $___________towards___________Degree
The no. of persons, who will accompany me:______________
I am sending herewith US $ ________as Offering.
I am sending herewith US $ ________For Scholarship for needy
need Pastors.
I am sending herewith US $ ________For Handicapped Ministry.
I am sending herewith US $ ________For Free Course Materials.
Amount Sent By: _______________
______________ Reference No: _________________________
________________________
Date: ………………………………………….
Signature: ………………………………………………………………………………….
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Attention please: 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.
Kindly Note: The Conference Registration Fees, Graduation Fees, Ordinati
Ordination
on Fees, Honorary
Doctorate Degree Fees and Gown Fees are non
non-refundable. Kindly bring the copy of the E-mail
pertaining to your payment and produce it in the Registration Counter at the Conference Venue.
Communication : If there is any change in your address, please inform us.
--- ---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
Nadu, India - 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
or 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 119th Convocation Scholarship.
My Name: - ………………………………
………………………………Associate
Associate Number…………………………
Number………………
My Address: - ……………………………………………………
…………………………………………………………..………………
………………
…………………………………………………………………….……………….…….
…………………………………………………………
…………………………………………………………ZipCode: ….…………….…….
….………
Phone Number:- …………………………… Cell:- ……...……………………………..
……...………………………
E-mail ID:Degree Chosen by me:- …………………… Language: - ……………………………
………………………
Date: - …………………
Signature: -…………………………………………
………………………………………………