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* Alternatively, write the above Admission ID# on a sheet of paper with the information requested on the form below (your name, address, email, etc) and bring it with you.

FIRST NAME:	_____________________________________
SURNAME:	_____________________________________
EMAIL:	_____________________________________
PHONE:	_____________________________________
MOBILE:	_____________________________________
ADDRESS:	_____________________________________
	_____________________________________
TOWN:	_____________________________________
POSTCODE:	_____________________________________
PRESENT JOB:	_____________________________________
INCOME GOAL:	_____________________________________
	_____________________________________

I will be attending with the following friends/relatives/colleagues:

NAME 1:	_____________________________________
EMAIL 2:	_____________________________________
PHONE 2:	_____________________________________
	_____________________________________
NAME 1:	_____________________________________
EMAIL 2:	_____________________________________
PHONE 2:	_____________________________________

It will be helpful if you also mark which lecture you attended. Please place a "X" to the left of whichever one you wish to attend / will have attended (this is optional).

[    ]	CHENNAI		[    ]	BANGALORE
[    ]	MUMBAI		[    ]	HYDRABAD
[    ]	PUNE
[    ]	GOA		[    ]	KOLKATTA (2009)
[    ]	COCHIN			requests??
[    ]	DELHI		[    ]
[    ]	PATNA		[    ]
			[    ]
			[    ]

Attention: Denis McCarthy
4 Life India’ Corporate Office,
86 Baba House, Opp Cinemagic Cinema,
MV Rd off Western Express Highway,
Andheri, E. Mumbai 4000,
Maharashtra, India

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