Registration Form - iceece-2015

Transcription

Registration Form - iceece-2015
VIVEKANANDHA COLLEGE OF ENGINEERING FOR WOMEN
(Autonomous)
DEPARTMENT OF CSE & EEE
Jointly Organize
INTERNATIONAL CONFERENCE ON ELECTRICAL, ELECTRONICS AND
COMPUTER ENGINEERING - ICEECE ‘15
Conference Proceeding ISBN: 978-93-81830-95-6
(ISI/Scopus indexed Journals& Annexure-I, Annexure-II Anna university Journal Publication)
11th & 12th March 2015
REGISTRATION FORM
Full Name (In capital)
: …………………………………………………………………………………
Designation
: …………………………………………………………………………………
Institution/ Company
: …………………………………………………………………………………
Category
: Research Scholars / Academicians / Student / Professionals
(Tick Appropriate)
Mailing Address
: …………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
Pincode
: …………………………………………………………………………………
Contact Numbers:
Office
: …………………………………………………………………………………
Mobile
: …………………………………………………………………………………
E-Mail ID
: …………………………………………………………………………………
Accommodation Required : YES /NO
Title of the Paper
: …………………………………………………………………………………
…………………………………………………………………………………
Paper ID
: ………………………………………………………………………………….
FEE DETAILS:
DD No
: ……………………………
Date
Issuing Bank
: ……………………………
Amount: …………………………………..
: …………………………………..
Students
Rs.2500
Research Scholars
Rs.3000
Academicians / Industry people
Rs.3500
Foreign Delegates
$ 100
1. Demand Draft: Registration fee is to be paid by a demand draft drawn in favor of “ICEECE -15" payable at
Elayampalayam.
2. Bank Transfer: Authors can just credit the registration fee in to the bank account given below and are
requested to send the soft copy of the bank transfer confirmation status to [email protected] .
Account Name
: ICEECE -15
Account No
: 182701000014847
Bank Name
: Indian Overseas Bank
Branch Code /Name
: 1827 / Vivekanandha College Campus Branch.
NEFT/IFSC
: IOBA0001827
Signature
VIVEKANANDHA COLLEGE OF ENGINEERING FOR WOMEN
(Autonomous)
DEPARTMENT OF CSE & EEE
INTERNATIONAL CONFERENCE ON ELECTRICAL, ELECTRONICS
& COMPUTER ENGINEERING
ICEECE 2015, March 11&12, 2015
COPYRIGHT FORM
Title of the Paper:
Author(s):
Declaration:
I/We assure the submitted paper is original and am/are the author of the paper.
I/We hereby declare that the paper has not been published or submitted in any other
conferences or journals.
Signature of Author(s) with name

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