Registration form

INTERNATIONAL CONFERENCE

‘EMERGING CHALLENGES AND PROSPECTS OF INDIAN ECONOMY’

18^th -19^th OCTOBER 2013

                                                                 REGISTRATION FORM

1-      Name (full name in Block letters)………………………….

2-      Sex      Male…………  Female  ………….       

 

3-      Designation………………………………………………….

4-      Official  Address…………………………………………………………………..

……………………………………………………………………………………..

…………………………………………………………………………………….

5-      Title of the Paper ……………..………………………………………………………………………

6-      Contact Nos.:  Office (with STD code)………………….Mobile………………….

7-      Member of GEA / IEA           YES / NO       Membership No of IEA ---------------

8-      Email id…………………………………………………………………………….

9-      Any accompanying person ………………………………………………………..

Numbers ( with sex and age)…………………………………......................................

9-Accommodation required* (Please indicate clearly)Yes/ No ………………………

10-Details of payment  D.D.  No. ……………………… Date……………………..

           Amount…..…………… Name of Bank & Branch………………………………

    

     11-Mode of Travel : Air/ Train/ Bus/Taxi

    

    Flight /Train/ Bus No…………………………………………………..

    Arrival Date…………………….. Time…………………………

    Departure Date………………… Time………………………….

    

    Signature …………………………….  Date…………………..

*Kindly note that the accommodation will be booked from 17^th to 19^th Oct, 2013