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SkidSec WebShell

Server Address : 172.31.38.4

Web Server : Apache/2.4.58 (Ubuntu)

Uname : Linux ip-172-31-38-4 6.14.0-1017-aws #17~24.04.1-Ubuntu SMP Wed Nov 5 10:48:17 UTC 2025 x86_64

PHP Version : 7.4.33



Current Path : /var/www/html/



Current File : /var/www/html/form_m2.php
<!-- <?php  -->
include('db.inc.php');
?>
<?php
$savedetails=$_POST['savedetails'];
if($savedetails=='saveapp')
{ //print_r($_POST);
$member = mysqli_real_escape_string($conn,$_POST['chk_member']);
$membership_no = mysqli_real_escape_string($conn,$_POST['membership_no']);
$company = mysqli_real_escape_string($conn,$_POST['company_name']);
$address = mysqli_real_escape_string($conn,$_POST['address_line']);
$representative_name = mysqli_real_escape_string($conn,$_POST['first_name']);
$gst_no = mysqli_real_escape_string($conn,$_POST['gst_no']);
$state = mysqli_real_escape_string($conn,$_POST['state']);
$city = mysqli_real_escape_string($conn,$_POST['city']);
$pincode = mysqli_real_escape_string($conn,$_POST['pincode']);
$phone = mysqli_real_escape_string($conn,$_POST['phone']);
$mobile = mysqli_real_escape_string($conn,$_POST['mobile_no']);
$email = mysqli_real_escape_string($conn,$_POST['email_id']);
$website = mysqli_real_escape_string($conn,$_POST['website']);
$manthan_category = mysqli_real_escape_string($conn,$_POST['manthan_category']);
$partcipant_name = mysqli_real_escape_string($conn,$_POST['partcipant_name']);
$partcipant_name2 = mysqli_real_escape_string($conn,$_POST['partcipant_name2']);
$designation = mysqli_real_escape_string($conn,$_POST['designation']);
$date = mysqli_real_escape_string($conn,$_POST['date']);
$ip = $_SERVER['REMOTE_ADDR'];

if(!empty($member) && !empty($company) && !empty($manthan_category))
{
$neelx="INSERT INTO `manthan_registration`(`member`, `membership_no`, `company`, `address`, `representative_name`,`gst_no`, `state`, `city`, `pincode`, `phone`, `mobile`, `email`, `website`, `manthan_category`, `partcipant_name`,`partcipant_name2`, `designation`, `date`, `ip`) 
VALUES ('$member','$membership_no','$company','$address','$representative_name','$gst_no','$state','$city','$pincode','$phone','$mobile','$email','$website','$manthan_category','$partcipant_name','$partcipant_name2','$designation','$date','$ip')";
$mysqlresults=$conn->query($neelx);
$signup_success = "Thank you! We will get back you for completing the Registration Process.<br/>
For any queries, please contact us, include the info from contact us page.
<br/>";

/********************* Send Email to Member ************************/
if($mysqlresults) {
$to = "$email";
$subject = "Thanks for Participation in MANTHAN";
$body ='<table width="96%" bgcolor="#fbfbfb" style="margin:2% auto; border:1px solid #ccc; font-family:Arial, sans-serif; color:#333333; font-size:13px;">
<tr>
<td style="padding:20px;">
    <table width="100%" border="0px" background="#fbfbfb" cellpadding="0px" cellspacing="0px">
    <tr>
        <td width="95px"><img src="http://www.gjf.in/images/logo.png" border="0" /></td>
        <td><img src="http://www.gjf.in/images/logo_text.png" border="0" style="margin:15px 0px; width:100%; max-width:431px;" /></td>
    </tr>
    <tr>
        <td colspan="2" height="10px"></td>
    </tr>
    <tr>
    	<td align="right" colspan="2" bgcolor="#ddd" height="1px"></td>
    </tr>
    <tr>
        <td colspan="2" height="10px"></td>
    </tr>
     <tr>
        <td colspan="2" style="font-size:13px; line-height:20px;">
        <p>Dear <strong>'.$representative_name.', </strong> </p>
        <p>You are successfully Registered in MANTHAN.</p>
        <p>Warm Regards,</br><strong>GJF</strong></p>
        <p>THIS IS A SYSTEM GENERATED MAIL. EMAILS TO THIS MAIL ID WILL NOT BE RESPONDED TO.</p>
        </td>
    </tr>
    <tr>
        <td colspan="2" height="10px"></td>
    </tr>
    <tr>
    	<td align="right" colspan="2" bgcolor="#ddd" height="1px"></td>
    </tr>
    <tr>
        <td colspan="2" height="10px"></td>
    </tr>
    <tr>
    <td align="right" colspan="2" height="30px" style="text-align:center; font-size:14px; font-weight:bold; text-transform:uppercase;">All India Gems & Jewellery Trade Fedarartion</td>
    </tr>
    <tr>
    <td colspan="2" align="center" style="font-size:13px; line-height:22px;">
    P & S Corporate House, Plot No. A-56, Road No. 1, 5th Floor, Near Tunga International, MIDC, Andheri (East), Mumbai - 400093<br />
    Tel : 022 67382727 , Email : <a href="mailto:info@gjf.in" style="color:#ca9967; text-decoration:none;">info@gjf.in</a> ,<br /> 
    Website : <a href="http://www.gjf.in" target="_blank" style="color:#ca9967; text-decoration:none;">www.gjf.in</a><br />
    </td>
    </tr>
    </table>
</td>
</tr>
</table>';

$headers  = 'MIME-Version: 1.0'."\n"; 
$headers .= 'Content-type: text/html; charset=iso-8859-1'."\n";
$headers .= 'From:GJF <do-not-reply@gjf.in>'."\n";
mail($to, $subject, $body, $headers);

/********************* Email Script Over ************************/
/********************* Send Email to Admin***********************/

	$to_admin = "gjfmanthan@gmail.com";
	//$to_admin = "neelmani@kwebmaker.com";
    $subject_admin = "Member Participation in Manthan "; //subject for mail to admin
    $message_admin = '<table width="96%" bgcolor="#fbfbfb" style="margin:2% auto; border:1px solid #ccc; font-family:Arial, sans-serif; color:#333333; font-size:13px;">
<tr>
<td style="padding:20px;">
    <table width="100%" border="0px" background="#fbfbfb" cellpadding="0px" cellspacing="0px">
    <tr>
        <td width="95px"><img src="http://www.gjf.in/images/logo.png" border="0" /></td>
        <td><img src="http://www.gjf.in/images/logo_text.png" border="0" style="margin:15px 0px; width:100%; max-width:431px;" /></td>
    </tr>
    <tr>
        <td colspan="2" height="10px"></td>
    </tr>
    <tr>
    	<td align="right" colspan="2" bgcolor="#ddd" height="1px"></td>
    </tr>
    <tr>
        <td colspan="2" height="10px"><p>GJF successfully registered in MANTHAN.</p></td>
    </tr>
	 <tr>
    	<td colspan="2" height="10px" ></td>
    </tr>
    <tr>
	<table border="0" width="500px;">
		<tr><td>Member</td><td>'. $member.'</td></tr>
		<tr><td>Membership No.</td><td>'. $membership_no.'</td></tr>
		<tr><td>Representative Name</td><td>'. $representative_name.'</td></tr>
		<tr><td>Company</td><td>'. $company.'</td></tr>
		<tr><td>GST No.</td><td>'. $gst_no.'</td></tr>
		<tr><td>Address</td><td>'. $address.'</td></tr>
		<tr><td>State</td><td>'. $state.'</td></tr>
		<tr><td>City</td><td>'. $city.'</td></tr>
		<tr><td>Pincode</td><td>'. $pincode.'</td></tr>
		<tr><td>Phone</td><td>'. $phone.'</td></tr>
		<tr><td>Mobile</td><td>'. $mobile.'</td></tr>
		<tr><td>Email</td><td>'. $email.'</td></tr>
		<tr><td>Manthan Category</td><td>'. $manthan_category.'</td></tr>
		<tr><td>Participant Name</td><td>'. $partcipant_name.'</td>
		<tr><td>Participant Name 2</td><td>'. $partcipant_name2.'</td>
		</tr>		
	</table>
		<p>Warm Regards,</br><strong>GJF</strong></p>
        <p>THIS IS A SYSTEM GENERATED MAIL. EMAILS TO THIS MAIL ID WILL NOT BE RESPONDED TO.</p>
    </tr>
    <tr>
        <td colspan="2" height="10px"></td>
    </tr>
    <tr>
    	<td align="right" colspan="2" bgcolor="#ddd" height="1px"></td>
    </tr>
    <tr>
        <td colspan="2" height="10px"></td>
    </tr>
    <tr>
    <td align="right" colspan="2" height="30px" style="text-align:center; font-size:14px; font-weight:bold; text-transform:uppercase;">All India Gems & Jewellery Trade Fedarartion</td>
    </tr>
    <tr>
    <td colspan="2" align="center" style="font-size:13px; line-height:22px;">
    P & S Corporate House, Plot No. A-56, Road No. 1, 5th Floor, Near Tunga International, MIDC, Andheri (East), Mumbai - 400093<br />
    Tel : 022 67382727 , Email : <a href="mailto:info@gjf.in" style="color:#ca9967; text-decoration:none;">info@gjf.in</a> ,<br /> 
    Website : <a href="http://www.gjf.in" target="_blank" style="color:#ca9967; text-decoration:none;">www.gjf.in</a><br />
    </td>
    </tr>
    </table>
</td>
</tr>
</table>';
$headers  = 'MIME-Version: 1.0'."\n"; 
$headers .= 'Content-type: text/html; charset=iso-8859-1'."\n";
$headers .= 'From:GJF <do-not-reply@gjf.in>'."\n";
mail($to_admin, $subject_admin, $message_admin, $headers);
} else { echo "something error";}
}
}
?>

<!DOCTYPE html>
<html xmlns="http://www.w3.org/1999/xhtml">
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
        <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1" />
        <title>GJC - Manthan</title>
        <link rel="shortcut icon" href="images/fav_icon.png" type="image/x-icon">
        <link rel="stylesheet" type="text/css" href="css/general.css" />
        <link rel="stylesheet" type="text/css" href="css/inner_pages.css" />
        <script src="js/1.8.3_min.js" type="text/javascript"></script>
        <script type="text/javascript" src="js/modernizr.custom.71422.js"></script>
        <script type="text/javascript" src="js/pushy.min.js"></script>
		<script src="js/jquery.validate.js" type="text/javascript"></script>
<script type="text/javascript">
$().ready(function() {
	$("#regisForm").validate({
		rules: {
			chk_member: {
			required: true,
			},
			membership_no: {
				required: true,
			},
			company_name: {
				required: true,
			},
			address_line: {
				required: true,
			},
			first_name: {
				required: true,
			},
			gst_no: {
				required: true,
			},
			state: {
				required: true,
			},
			city: {
				required: true,
			},
			pincode: {
				required: true,
				number:true
			},
			phone: {
				required: true,
				number:true
				},
			mobile_no: {
				required: true,
				number:true,
				minlength: 10,
				maxlength:10
			},
			email_id: {
				required: true,
				email:true
			},
			manthan_category: {
				required: true,
			},
			partcipant_name: {
				required: true,
			},			
			designation: {
				required: true,
			}, 
			date:{
				required: true,
			}
		},
		messages: {
			chk_member: {
				required: "Are you a GJF Member",
			},
			membership_no: {
				required: "Please Enter Membership No",
			},
			company_name: {
				required: "Please Enter Company Name",
			},
			address_line: {
				required: "Please Enter Your Address",
			},
			first_name: {
				required: "Please Enter your Name",
			},
			gst_no: {
				required: "Please Enter your GST No.",
			},
			state: {
				required: "Please Enter State",
			},
			city: {
				required: "Please Enter City",
			},
			pincode: {
				required: "Please Enter Pincode",
				number:"Please Enter Numbers only"
			},
			phone: {
				required:"Please Enter Phone Number",
				number:"Please Enter Numbers only"
			},
			mobile_no: {
				required:"Please Enter Mobile Number",
				number:"Please Enter Numbers only",
				minlength:"Please enter at least {10} digit.",
				maxlength:"Please enter no more than {0} digit."
			},
			email_id: {
				required: "Please Enter a valid Email id",
			}, 
			manthan_category: {
				required: "Choose Category",
			},
			partcipant_name: {
				required: "Enter Partcipant Name",
			},
			designation: {
				required: "Please Enter Designation",
			},
			date: {
				required:	"Please Choose Date",
			}
	 }
	});
});
</script>

<script type="text/javascript">
    $(document).ready(function () {
        $("input[name='chk_member']").click(function () {
            if ($("#memYes").is(":checked")) {
                $("#msme_main").show();
            } else {
                $("#msme_main").hide();
            }
        });
    });
</script>
<script type="text/javascript">
    $(document).ready(function () {
        $("input[name='chk_member']").click(function () {
            if ($("#memYes").is(":checked")) {
				$("#msme_main").show();
                $("#membership_no").show();
				$("#membership_no").prop("disabled", false);	
            } else {
                $("#msme_main").hide();
				$("#membership_no").prop("disabled", true); 
				$("#membership_no").style.display = 'none';
            }
        });
    });
</script>

</head>

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<li><a href="#">Manthan </a>
                        <ul>
                        <li><a href="manthan.html">About Manthan</a></li>
                        <!-- <li><a href="conclave_topics.html">Conclave Topics </a></li> -->
                       <!--  <li><a href="speakers.html">Manthan Speakers</a></li> -->
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                         <!-- <li><a href="form_m2.php">Registration Form</a></li> -->
                        <!-- <li><a href="contact_manthan.html">Contact Us</a></li>-->
                        </ul>
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<li><a href="contact_us.html">Contact Us</a> </li>
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<div class="login fade_anim"><a href="election.html" class="electn">Election 2016</a><!--<a href="#"><img src="images/login_icon.png" title="Login"><span style="font-size:11px;">MEMBERS</span><br>LOGIN</a>--></div>
</div>
</div>
</div>
<!-- -------------------------------- header ends ------------------------------ -->
<!-- -------------------------------- container starts ------------------------------ -->
<div class="container_wrap">
<div class="inner_banner">
<img src="images/manthan/banner.jpg">
</div>
<div class="inner_main inner_list">
<div class="left_main">
<h1 class="pg_title">MANTHAN APPLICATION FORM FOR PARTICIPATION</h1>

<?php if(isset($signup_success)){ echo "<span style='color: green;'>".$signup_success.'</span>';} else {?>
<form method="post" name="regisForm" id="regisForm"/>
<input type="hidden" name="savedetails" value="saveapp">
<div class="form-group frm_new1 margin_form">
<div class="chkbox">       
<input type="radio" id="memYes" value="Yes" name="chk_member"> <span style="padding-right: 15px;">YES</span>
<input type="radio" id="memNo" value="No" name="chk_member"> <span>NO</span>
<label for="chk_member" generated="true" class="error" style="top: 10px; left: 280px; display:none;">Are you a GJC Member</label>
</div>
<span class="highlight"></span> <span class="bar"></span>
<label class="toplbl"> Are you a GJC Member </label>
</div>

<div class="form-group frm_new1" id="msme_main" style="display: none">
<input type="text" class="form-control" name="membership_no" id="membership_no" autocomplete="off" maxlength="20"/>
<span class="highlight"></span> <span class="bar"></span>
<label>GJC Membership No.</label>
</div>

<div class="form-group frm_new1">
<input type="text" class="form-control" name="company_name" id="company_name"  autocomplete="off"  maxlength="20"/>
<span class="highlight"></span> <span class="bar"></span>
<label>Name Company / Individual</label>
</div>

<div class="form-group frm_new1">
<input type="text" class="form-control" name="address_line" id="address_line"  style="height: 50px;">
<span class="highlight"></span> <span class="bar"></span>
<label>Address of the Company / Individual</label>
</div>

<div class="form-group frm_new1">
<input type="text" class="form-control" name="first_name" id="first_name"  autocomplete="off" maxlength="20"/>
<span class="highlight"></span> <span class="bar"></span>
<label>Name of representative</label>
</div>

<div class="form-group frm_new1">
<input type="text" class="form-control" name="gst_no" id="gst_no"  autocomplete="off" maxlength="20"/>
<span class="highlight"></span> <span class="bar"></span>
<label>GST No.</label>
</div>

<div class="form-group frm_new">
<input type="text" class="form-control" name="state" id="state"  autocomplete="off" maxlength="15"/>
<span class="highlight"></span> <span class="bar"></span>
<label>State</label>
</div>

<div class="form-group frm_new">
<input type="text" class="form-control" id="city" name="city"  autocomplete="off" maxlength="15"/>
<span class="highlight"></span> <span class="bar"></span>
<label>City / Town </label>
</div>
<div class="clear"></div>
<div class="form-group frm_new">
<input type="text" class="form-control" id="pincode" name="pincode"  autocomplete="off" onKeyPress="if(this.value.length==10) return false;"/>
<span class="highlight"></span> <span class="bar"></span>
<label>Pin Code</label>
</div>

<div class="form-group frm_new">
<input type="text" class="form-control" id="phone" name="phone"  autocomplete="off" onKeyPress="if(this.value.length==15) return false;"/>
<span class="highlight"></span> <span class="bar"></span>
<label>Phone</label>
</div>

<div class="clear"></div>
<div class="form-group frm_new">
<input type="text" class="form-control" id="mobile_no" name="mobile_no"  autocomplete="off" onKeyPress="if(this.value.length==10) return false;"/>
<span class="highlight"></span> <span class="bar"></span>
<label>Mobile</label>
</div>

<div class="form-group frm_new">
<input type="text" class="form-control" id="email_id" name="email_id"  autocomplete="off"/>
<span class="highlight"></span> <span class="bar"></span>
<label>Email</label>
</div>

<div class="clear"></div>
<div class="form-group frm_new">
<input type="text" class="form-control" id="website" name="website"  autocomplete="off"/>
<span class="highlight"></span> <span class="bar"></span>
<label>Website</label>
</div>
<div class="clear"></div>

<div class="fees_wrap">
<h2 class="manthan_heading gold_color">Manthan Conclave Category 
<label for="manthan_category" generated="true" class="error" style="top: 1184px; left: 450px; display:none;">Choose Category</label></h2>
<label for="Platinum_plus" class="plat_lable">
<div class="info_pay">
<div class="infopay_head">
<input class="radio" id="manthan_category" type="radio" name="manthan_category" value="Platinum Plus"/>
<h2> PLATINUM PLUS</h2>
</div>
<p><span>Rs. 25000</span>
+ Tax Includes Five Star Accommodation for one night &
2 Tickets (Representatives of the same company) of Platinum Seating</p>
</div>
</label>
<label for="Platinum" class="plat_lable">
<div class="info_pay info_pay2">
<div class="infopay_head">
<input class="radio" id="manthan_category" type="radio" name="manthan_category" value="Platinum"/>
<h2>PLATINUM </h2></div>
<p><span>Rs. 15000 </span>
+ tax Includes 2 Tickets (Representatives of the same company) of Platinum Seating</p>
</div>
</label>
<label for="Diamond" class="plat_lable">
<div class="info_pay">
<div class="infopay_head">
<input class="radio" id="manthan_category" type="radio" name="manthan_category" value="Diamond"/>
<h2>DIAMOND PLUS</h2></div>
<p><span>Rs. 15000 </span>
+ tax Includes 2 Tickets (Representatives of the same company) of Platinum Seating</p>
</div>
</label>
<label for="Diamond" class="plat_lable">
<div class="info_pay info_pay2">
<div class="infopay_head">
<input class="radio" id="manthan_category" type="radio" name="manthan_category" value="Diamond"/>
<h2>DIAMOND</h2></div>
<p><span>Rs. 5000</span>
+ Tax Includes One Ticket of Diamond Seating</p>
</div>
</label>
<div class="clear"></div>
<div class="pay_wrap">
<!-- <div class="part_info">
<p>Last date to Participate / Pay before &nbsp;
<span class="gold_color">30th March, 2018</span></p>
</div> -->
<p>* Prices mentioned above are for GJC members. Additional 10 % for non members</p>
<div class="clear"></div>
</div>
<div class="payment_1">
	<p>You can make the payment as per the following –</p>
	<ul class="general_list">
	<li>Send a cheque / Demand draft in the name of "All India Gems & Jewellery Trade Federation" to-
All India Gems & Jewellery Trade Federation, 6th Floor, P & S Corporate House, Plot No. A-56, Road No.1, Behind Hotel
Tunga International, M.I.D.C., Andheri (East), Mumbai – 400 093. Maharashtra / India.</li>
	

<li>NEFT / RTGS details: Bank Name- HDFC BANK LTD • Address- S’ana Building, Linking Road, Santacruz (W), Mumbai – 400054.
Account Type - Current • Name - ALL INDIA GEMS & JEWELLERY TRADE FEDERATION • Account No. 00792320003428
RTGS/NEFT IFSC : HDFC0000079</li>
	
</ul>

</div>
</div>

<div class="tc_wrap">
<h2 class="manthan_heading gold_color">Terms and conditions applicable to registered participants</h2>
<p>
These terms and conditions refer to organisers of the event "Manthan" as <b>"GJC"</b>
and those who have registered for the event as <b>"Participants"</b>
</p>
<div class="event_box">
<div class="expand tl fade_anim"><h2>Registration Fees :</h2></div>
<div class="expand_area contentbox">
<ul class="general_list">
<li> Participant should not be below 15 years of age at the time of registration.</li>
<li>Participant should carry identification proof indicating age at the time of registration.</li>
<li> Participant must be a person belonging to the organization of member of GJC.</li>
<li>Registration fees once paid shall not be refundable save and except as herein below provided.</li>
<li>GJC reserves right to cancel or reschedule the said event in case of circumstances beyond control. Discretion of GJC that circumstances are beyond control is absolute and binding on Participants.</li>
<li>In case the event is rescheduled, GJC shall use reasonable endeavor to communicate the rescheduled date and agenda to the Participants based on the information provided in the registration form. However, it shall be the sole responsibility of Participant to check with GJC about status of event. In the event registered Participant is unable to attend the event on the rescheduled date, may nominate any other person belonging to the organization of member of GJC to attend the event on the rescheduled date by intimating GJC in writing seven days in advance. However, under no circumstances registration fees shall be refunded.</li>
<li>In case event is cancelled, liability of GJC shall be limited to full refund of the registration fees only. GIF shall not be liable for any interest or any travel or hotel cost incurred by any Participant or any cost of whatsoever nature incurred by any Participant in case of such cancellation.</li>
</ul>
<div class="clear"></div>
</div>
</div>
<div class="event_box">
<div class="expand tl fade_anim"><h2>Attendance :</h2></div>
<div class="expand_area contentbox">
<ul class="general_list">
<li>In case registered Participant wishes to nominate any other person
<b>belonging to the organization of member of GJC</b> to attend the event instead of himself/herself, the same shall be communicated in writing to GJC seven in advance together with additional fees of Rs. 1000/- (Rupees One Thousand Only).<br>The said additional fees shall be paid by <b>cheque/ wire transfer</b></li>
<li>GJC admits no liability in case any Participant is unable to attend the event due to adverse weather condition or travel disruption or any reason whatsoever.</li>
</ul>
<div class="clear"></div>
</div>
</div>
<div class="event_box">
<div class="expand tl fade_anim"><h2>Content of the event and speakers :</h2></div>
<div class="expand_area contentbox">
<ul class="general_list">
<li>It may be necessary for reasons beyond control to change the content and or timing of the event, the speakers, the date or the venue at any time prior to event. GJC shall at its sole discretion take such decisions and make best endeavor in respect thereof. GIF admits no liability in respect of any change as stated herein above.</li>
</ul>
<div class="clear"></div>
</div>
</div>
<div class="event_box">
<div class="expand tl fade_anim"><h2>Force Majeure :</h2></div>
<div class="expand_area contentbox">
<ul class="general_list">
<li>If the event is abandoned, cancelled or suspended in whole or in part by reason of war, fire, national emergency, labour dispute, strike, lock-out, civil disturbance, inevitable accident, the non-availability of the venue or any other cause not within the control of GJC, GJC may at their entire discretion, repay the registration fees paid by Participant, or part thereof, but shall be under no obligation to do so. GIF shall be under no liability to the Participants in respect of any actions, claims, losses (including consequential losses), costs or expenses whatsoever which may be brought against or suffered or incurred by the Participant, as the result of the happening of such an event.</li>
</ul>
<div class="clear"></div>
</div>
</div>
<div class="event_box">
<div class="expand tl fade_anim"><h2>Liability for loss or damage :</h2></div>
<div class="expand_area contentbox">
<ul class="general_list">
<li>GJC admits no liability in respect any loss or damage to property of any Participant.</li>
</ul>
<div class="clear"></div>
</div>
</div>
</div>
<div class="declare_wrap">
<h2 class="manthan_heading gold_color">Declaration</h2>
<p>I confirm, as an individual or on behalf of my Organization that I/we am/ are part of the Jewellery industry either as retailer or
wholesaler or manufacturer or designers or gold smiths. I / We will abide by the terms & conditions of the 'MANTHAN CONCLAVE
2018' and accept all the terms & conditions specified in the form. I confirm my / our eligibility to take part in this Conclave and that all information in this application and accompanying documents are correct to the best of my knowledge.</p>

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* The Application Form needs to be signed by the authorized signatory from the participant
organization or by the Participant himself (Proprietor, Partner, Owner, Director or any member of the
Senior Management of the Organisation)
</p>
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<?php }?>


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