verlekar

Comments

Transcription

verlekar
The Role of Spirituality in the age of Science and Technology
9th All India Students’ Conference on
Science and Spiritual Quest
30th October – 1st November 2015
IIT Kharagpur, India
www.aissq.org
REGISTRATION
FORM FOR
PROFESSIONALS
ONLY
(OFFLINE)
Send duly filled advance copy of registration form (without DD) via Email, thereafter followed by original signed
copy along with DD by post to the registration coordinator
Send duly filled advance copy of registration form (without DD) via Email, to [email protected] thereafter
followed by original signed copy along with DD by post to the registration coordinator. (Details on next page
and also on: http://www.aissq.org)
Name:
(type/print
in block
letters)
Male
Surname/Family name
First name
Middle name
Female
Age
Sex
Designation:
Your designation/position in your organization (Software/Professor/ Director/ Manager etc.)
Organization/
Institute:
Correspondence
Address:
City:
State:
Phone:
Country:
Fax:
PIN:
Email:
YES
Your views on the following:

Do you want to see a culture of harmony and peace among the nations?

Will you be part of the vision 2020 to see India a developed country with a perfect
balance of science and spirituality?

Do you feel the need of a continued dialogue on Science and Spirituality?
NO
How the science and spirituality dialogue will lead to a peaceful world? (restrict to space provided below)
Registration Fee: Demand draft in favor of AISSQ payable at Kolkata
Category
Professionals
Corporate Sponsored Delegates
With Accommodation (Rs)
2500/5000/-
Without Accommodation (Rs)
1500/2500/-
Foreign Delegates (US$)
$120
$500
DD/Net Banking details:
DD Number /Net Banking transaction no.:
Amount:
Bank:
Date:
# Are you travelling with your spouse?
YES:
NO:
If Yes, Name of your Spouse:
Place
Date
Signature
©Bhaktivedanta Institute, Kolkata
TERMS & CONDITIONS

Send advance copy of application for registration (without DD) only to registration coordinator by email

Send duly filled registration form + DD/Net transaction Id details + Xerox of ID Card (both sides) by post/courier to
the registration coordinator.

Participation in the conference will not be allowed without confirmed registration.

A delegate who is not shortlisted will be refunded 80% of the registration fee. This deduction is towards processing, bank
charges and postage costs. Refund can take about 90 -120 days from the last date of registration.

Last date of sending duly filled registration application form along with registration fees to Coordinator: 30 Sep 2015

Last date of Email-confirmation of registration to participants by registration coordinator: 15 October 2015.

List of confirmed participants on conference website: 15 October 2015.

For Indian participants, DD should be drawn in favour of AISSQ payable at Kolkata. For Net Banking, please note the
following details: Account name: AISSQ; Account No: 037101001886; Bank: ICICI Bank; RTGS/NEFT Code(IFSC):
ICIC0000371; Branch: VIP Road Branch, "Swastik Building", Ground Floor, Ward No. 7, Nazrul Islam Sarani, Kolkata 700 059

For participants from abroad, DD should be drawn in favor of "Bhaktivedanta Institute" payable at Kolkata.

Registration is not transferable.

Once registered, No refund of registration fee if one does not participate in the conference.
In case of any further queries with regard to registration, please contact registration coordinator (P.
at [email protected]
Pavan Kumar)
Note: All Email correspondences with the registration coordinator (P. Pavan Kumar) related to the 9th All India Students’
Conference on Science and Spiritual Quest, 30th Oct – 1st Nov 2015 IIT Kharagpur, West Bengal SHOULD ONLY be through
the Email address: [email protected]
Registration Coordinator Information
P. Pavan Kumar
Joint Secretary - AISSQ2015
Room No. 5/204,
Zakir Hussain Hall of Residence
IIT Kharagpur Campus
Kharagpur, West Bengal-721302, INDIA
Email: [email protected]
Cell No: +91-7602516554,
+91-9871642322

Similar documents