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Online Registration Form

FIFTH NATIONAL CONVENTION ON STUDENTS’ QUALITY CIRCLE, 2009

26-28 November 2009

Convention Secretariat - Galaxy Public School
Gyaneshwar, Kathmandu, Nepal
P.O. Box No.: 4901
Tel: 4410076, 4411362, 4438201, 4414584, 4412578, 4425076
Fax: 977-1-4416989
Email: galaxysqc@gmail.com  |  Website: www.galaxy.edu.np

Please complete this form and click Submit below
2. Name of the Teacher Representative/s  (Note: Maximum of two teachers can come with the delegation)
Male:
a. b.
Female:
a. b.
3. Participation in programmes (please tick)
I Case Study Presentation (non competitive event)
II Speech Contest (only for a girl student)
III English Spelling Contest (only for students of grade 6, 7 and 8)
IV Poster and Slogan Contest
V Traditional Nepalese Instrument Contest
VI Story Forming Contest
VII Collage Contest (only for student s of grade 4 and 5)
VIII Students’ Panel Discussion (non competitive event, through invitation only)
Note: Events I and VIII can be both in English or Nepali medium. Rest of the events will be in English medium only. Each participant can apply for only one event (contest or presentation)
4. Total Number of people in the delegation
Teachers:
Male: Female:
Students:
Male: Female:
5. List of Participants  (Please provide full name of each participants)
I. Case Study Presentation (non competitive event)
A B
C D
E F
G H
I J
Note: Total number of participants should be 4 to 10.
II. Speech Contest (only for a girl student)
A
III. English Spelling Contest (only for students of grade 6, 7 and 8)
A B
IV. Poster and Slogan Contest
A B
V. Traditional Nepalese Instrument Contest
A B
C D
E
Note: Maximum of 5 students can participate
VI. Story Forming Contest
A B
C
VII. Collage Contest (only for student s of grade 4 and 5)
A B
6. School/Institution Details
Phone No (with STD code) Fax No (with STD code)
Email (mandatory) Mailing Address (including post box)
7. Participation Fee Payment Details (IMPORTANT)
  • The Registration fee is NRs. 250 per participant.
  • Registration fee for two teachers accompanying each participating team is waived.
  • Total registration fee should be sent through T.T. or Demand Draft payable to:
    Galaxy Public School
    Account No. 2101200 at Nepal Investment Bank, Durbarmarg Branch
  • The registrations will not be processed until the fee payment is received in the provided bank account number.
  • No refund will be provided for cancellation of the registration.
  • The last day of registration is Friday, 30 October 2009.
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