[Please complete this form andsend it to the Symposium secretariat by e-mail () or by fax.]
Personal Information Of the Participant
Please type or print clearly in CAPITAL LETTERS.
Title: [ ]Mr. [ ]Mrs. [ ]Ms. [ ]Prof. [ ]Dr. [ ]Others (Please specify:______)
Full Name: ______
Function at conference:[ ] AcademicDelegate [ ]Student Delegate[ ]Industrial Delegate
University/Organization: ______
City: ______Country: ______
Telephone: ( )______Fax: ( )______
Email: ______
Manuscript Identification Code______
Registration Fees
Registration Fee
/Before Aug 30, 2012
/After Aug 30, 2012
Regular Participants / USD 500 / USD 550Students / USD 250 / USD 350
Accompanying Person / USD 100 / USD 100
For Indian Delegates
Regular Participants / IRs.9,000 / IRs.10,000Students / IRs.3,000 / IRs.3,500
Accompanying Person / IRs.2,000 / RRs.2,000
All bank charges will be to the senders account.
Registration Fee for the Participant: ______
Registration Fee for students: ______
Registration Fee for accompanying persons: ______
Print full name of guest(s): ______
Total Amount: ______
Money Transaction Narration Details ______
______
Date ______Signature of the Participant ______
NOTE: For each registration, a maximum of two papers can only be accepted for inclusion in the symposium. Delegates with more than two papers are required to register twice.
PAYMENT METHOD
For delegates from abroad / For Indian ParticipantsPlease use telegraphic mode for payments as per the following details:
Account Name: PFAM-21
Account type: Savings
Account No. 32279956415
Name of Bank :State Bank of India,
Branch : IIT Guwahati, India, Branch code: 14262
Swift Code: SBININBB159,
Please mention the Transaction Narration during the Telegraphic Transfer.
Payment by Cheque: Please make cheques payable to "PFAM-21". /
- In the form of Demand Draft (A/C payee) drawn in Favor of “PFAM-21” payable at IIT Guwahati (code: 14262).
- Online bank transfer/cash deposit through Core Banking..
- Please mention the Transaction Narration during the Money Transfer.
- Any bank charge is to be borne by the depositor.
Name of Bank :State Bank of India,
Branch : IIT Guwahati, India,
Branch code: 14262
Account Name: PFAM-21
Account No. 32279956415
IFSC Code: SBIN0014262
BSR Code: 0014262
MICR Code: 781002053
- All bank charges is to be borne by the depositor.
- Please send the receipt of the money transfer to the symposium secretariat by e-mail
Please complete the form and send by e-mail to the Conference Secretariat. Should you have any questions, please do not hesitate to contact us.
E-Mail:Phone:+91-3612582668Fax:+91-361-2582699
Professor P.S. RobiOrganizing Secretary, PFAM-21
Professor, Department of Mechanical Engineering,
Indian Institute of Technology Guwahati
Guwahati , 781039- India
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