Registration Form BDAB 2016

I/We nominate following person(s) to participate in the conference. Please register accordingly:
Name
Designation
E Mail
Ph. No.
Name
Designation
E Mail
Ph. No.
Organisation Name: ___________________________________________________________________________________________
Address: ________________________________________________________________________________________________________
City__________________________________Tel/Cell: _______________________________ Email: __________________________________
Please Select [ √ ]the Category of Registration:
Registration fee includes access to conference venue, workshops and demonstrations, keynotes, lunches and
refreshments during the conference days and the participation certificate. Payment instructions and registration form is
available on the conference website: www.serd.org.in/bdab2016
REGISTRATION REMITTANCE Via Demand Draft/Cheque No.______________________________ Dated ___________________ Rs. ___________________
(Authorized Signatory)
Fee is payable by DD/ Cheque in favour of ‘Society for Education and Research Development’ payable at New Delhi.
Online Payment details
Beneficiary Name
: Society for Education and Research Development
Account No.
: 05291131002000
Bank Name
: Oriental Bank of Commerce
IFSC Code
: ORBC0100529 (For Transfers from India)
Swift Code
: ORBCINBBIBD (For Transfers from Abroad)
Delegates can pay by Credit Cards /Paypal account through link given on the website. Receipt will be generated by Paypal.
Please inform us of the transaction details once payment is made/ DD & Registration Form is dispatched.
Contact Details:
Dr. Saurabh Mittal
Conference Convener
Mobile: +91 9818253275
[email protected], [email protected]
www.serd.org.in/bdab2016