RGL East Meetings

Constitution

Region

Lodge Name Lodge Name (for GLI members)

APPLICATION No

Title

Name

Address

City

State

Mobile

Whatsapp (if different from Mobile)

REGISTRATION PARTICULARS

Registration

Registration Amount

SPOUSE DETAILS

Patrons and Governor are eligible for complimentary food coupons for their spouse.

Name

Mobile

TRAVEL - New Jalpaiguri Junction / Bagdogra Airport

After selecting the date, click on the clock icon at the base to select the time

Arrival Date and Time

Arrival Mode

Arrival Description

Departure Date and Time

Departure Mode

Departure Description

HOTEL ACCOMODATION

Available Hotel Rooms

Central Heritage Resort - 37

Choice of Hotel

Room Type

Extra Bed

No. of Days of Stay

Total Amount

FOOD PREFERENCE

Friday

Mason

Spouse

Saturday

Mason

Spouse

EMERGENCY CONTACT

Contact Person Name

Contact Mobile No

SPECIAL INSTRUCTIONS

Any request / special medical condition to be aware of

REMITTANCE PARTICULARS

For delegates paying online; please select the name of the bank from which you have transfered the funds

Payment Type

Cheque No/Online Transaction No

Bank Name

Amount

INSTRUCTIONS

Cheque should be drawn in favor of REGIONAL GRAND LODGE OF EASTERN INDIA

In case of payment by Cheque / Demand Draft, kindly mention your NAME and LODGE ID on the reverse of the Cheque / DD

In case of ONLINE TRANSFERS, please select the Bank Name from which you have made the transfer.

BANK DETAILS for online transfer are as follows : Account Name: REGIONAL GRAND LODGE OF EASTERN INDIA | State Bank of India, Park Street | Account No.: 1095 9192 459 | IFSC Code: SBIN0000150
UPI ID : 10959192459@sbi

REGISTRATION FORM - RGLEI HYM at Darjeeling

Available Hotel Rooms