| Signature |
| REGISTRATION |
1. Name ______________________________________________________
2. Designation _______________________________________________
3. Address ___________________________________________________ _____________________________________________________________ ____________________________________________________________ _____________________________________________________________
4. Telephone/Fax Nos. _________________________________________
5. E.Mail ______________________________________________________
6. Telegraphic Address ________________________________________
7.
| Presenting Paper | Oral Yes / No |
| Poster Yes / No |
8. Title of the paper :
Enclosed: Abstract / Paper (e –version and hard copy): (Please ensure CD is virus free)
9. Accommodation Required : Yes / No if yes: Hotel / Hoysala House (IISc campus)