Registration Form
Nominator Details
First Name* Last Name*
Designation*
Company*
Site / Unit
Department
Address*
City* PIN*
STD Code* Direct Phone*
Mobile*
Official Email*
Personal Email
Nominations
1. Certification*
  Fee
Select a course from above drop down
  First Name*
Last Name*
  Designation*
  Company*
same as nominator
  Site / Unit
  Department
  Address*
same as nominator
  City*
Pin*
  STD Code*
Direct Phone*
  Mobile*
  Official Email*
  Personal Email
2. Certification
  Fee
Select a course from above drop down
  First Name
Last Name
  Designation
  Company
same as nominator
  Site / Unit
  Department
  Address
  City
Pin
  STD Code
Direct Phone
  Mobile
  Official Email
  Personal Email
3. Certification
  Fee
Select a course from above drop down
  First Name
Last Name
  Designation
  Company
same as nominator
  Site / Unit
  Department
  Address
  City
Pin
  STD Code
Direct Phone
  Mobile
  Official Email
  Personal Email
4. Certification
  Fee
Select a course from above drop down
  First Name
Last Name
  Designation
  Company
same as nominator
  Site / Unit
  Department
  Address
  City
Pin
  STD Code
Direct Phone
  Mobile
  Official Email
  Personal Email
5. Certification
  Fee
Select a course from above drop down
  First Name
Last Name
  Designation
  Company
same as nominator
  Site / Unit
  Department
  Address
  City
Pin
  STD Code
Direct Phone
  Mobile
  Official Email
  Personal Email
Total Amount Due:
Please verify that the details you have entered are correct.
This information will be used to communicate with you regarding your registration.
Registration fee includes:
Enrollment Fee
Study Material
Examination Fee
Applicable Taxes
Additional benefits:
Special discounted rates for attendance to Qimpro's seminars, conferences and workshops on quality and excellence
Free subscription to Qimpro’s e-Newsletters
   
   
Qimpro College, A division of Qimpro Consultants Pvt. Ltd.
1C Sindhu House, Nanabhai Lane, Fort, Mumbai 400 001, India | (91-22) 6634 8701 | college@qimpro.com