Regional Grand Lodge of Southern India

REGISTRATION FORM - HYM 2025 at Thrissur

Attn : Members of Lodges in RGL Southern India - please select your name from the drop down list of members.
You can search by name, mobile, email
You address, mobile and email will be fetched automatically on the form

Constitution

Region

Lodge

Title

Name

RGLSI Id

Address

City

State

Country

Mobile

Whatsapp (if diff. from Mobile)

REGISTRATION PARTICULARS

Registration

Registration Amount

Attending Diamond Jubilee

Mark Lodge

SPOUSE DETAILS
Please tick if Spouse is Attending

Name

Mobile

Attending Ladies Program

TRAVEL
In Arrival Description -FOR TRAINS, type a few characters of the train name or train number. FOR FLIGHTS, type a few characters of your airline or your arrival/destination city

Arrival Date

Arrival Mode

Arrival Description

Departure Date

Departure Mode

Departure Description

Staying at (Name of Hotel)

FOOD PREFERENCE
Please tick the days you are attending

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

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INSTRUCTIONS

REGISTRATION FORM - HYM 2025 at Thrissur

BANK ACCOUNT FOR REMITTANCE

Name of A/c : RGLSI HYM 2025
Bank : HDFC Bank
Branch : Peringavu
A/c Type : Current
A/c No. : 5020 0109 3812 60
IFSC Code : HDFC0006497

UPI ID :

REGISTRATION FORM - HYM 2025 at Thrissur

BANK ACCOUNT FOR REMITTANCE

Name of A/c : RGLSI HYM 2025 Bank : HDFC Bank Branch : Peringavu A/c Type : Current A/c No. : 5020 0109 3812 60 IFSC Code : HDFC0006497 UPI ID :

Name of A/c : RGLSI HYM 2025
Bank : HDFC Bank
Branch : Peringavu
A/c Type : Current
A/c No. : 5020 0109 3812 60
IFSC Code : HDFC0006497

UPI ID :