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Multidisciplinary International Conference on "INNOVATIVE IDEAS IN THE FIELDS OF SCIENCE, SOCIAL SCIENCES AND MANAGEMENT” Organized by : Shri Jagdish Prasad Jhabarmal Tibrewala University in association with : J. Watumull Sadhubella Girls College, Ulhasnagar (M.S.) India and International Cultural Forum, Mauritius in jointly Collaboration with : Udayana University Bali, Indonesia MAY 19-24, 2018 REGISTRATION FORM Prof./Dr. / Mr. / Ms. .......................................................... ......................................................... Name : ....................................................... .............................................................. ................... (Surname) (First Name) (Middle Name) Designation : ................................................ .............................................................. ................ Organization : ............................................... .............................................................. ................ Address : .................................................... .............................................................. ...................
Transcript of sadhubellacollege.orgsadhubellacollege.org/.../03/Registration-Form-Word.docx · Web...
Multidisciplinary International Conference on"INNOVATIVE IDEAS IN THE FIELDS OF SCIENCE, SOCIAL SCIENCES AND MANAGEMENT”
Organized by : Shri Jagdish Prasad Jhabarmal Tibrewala Universityin association with : J. Watumull Sadhubella Girls College, Ulhasnagar (M.S.) India and
International Cultural Forum, Mauritius in jointly Collaboration with : Udayana University Bali, Indonesia
MAY 19-24, 2018
REGISTRATION FORM
Prof./Dr. / Mr. / Ms. ...................................................................................................................
Name : ........................................................................................................................................
(Surname) (First Name) (Middle Name)
Designation : ..............................................................................................................................
Organization : .............................................................................................................................
Address : .....................................................................................................................................
....................................................................................................................................................
Country : .................................................. PIN/Zip code :...........................................................
Email : .........................................................................................................................................
Contact (M) : .................................................. (R)......................................................................
Whether submitting abstract Yes/ No for Oral /Poster
Title of the Paper : ......................................................................................................................
....................................................................................................................................................
Payment Mode: DD / Bank Transfer through RTGS/NEFT
D.D. No/UTR No. ......................................................... Date : ...................................................
Drawee Bank :.......................................................... Amount Rs. : ...........................................
Passport Details/ID Proof : .........................................................................................................
BANK DETAILS AND ACCOUNT NUMBER : SignatureBank Name: Bank of BarodaAccount Name : Crossways Tours & TravelsAccount No: 04240200007559IFSC Code: BARBOTHANAXMICR Code: 400012079Bank address: Annapurna,Gokhale Road,Naupada,Thane (W),Phone: 022-25422714
