ANNUAL CONFERENCE 2009

REGISTRATION FORM

(Please fill up the form given below and send it to the organizers through email or by post)

Participant’s Name in Full: ___________________________________________

Profession:     _____________________________________________________

(Professor/ Teacher/ Research Scholar/ Columnist/ Journalist/ Mediaperson/ Student/ Patron/ Supporter/ Donor/ Other)

University/College/Institute/Organisation:   _____________________________

Educational Qualification:  ___________________________________________

Nationality:  ______________________________________________________

Date of Birth:  ____________________________________________________

Male/Female: _____________________________________________________

Full Address:    ____________________________________________________

______________________________________________________

______________________________________________________

Email Address:   ___________________________________________________

Tel:                  ____________________________________________________

Mobile:            _____________________________________________________

Sessions of Interest:  ________________________________________________

__________________________________________________________________

Intended participation as:   _________________________________________

(Paper Presenter/ Organiser / Panelist/ Supporter /Donor /General Observer/Intervener /Any other)

List any special accommodations or assistance you need in order to participate in this conference:

________________________________________________________________

Submit Registration Form To:

INACS
Lower Ground Floor,
B-27, Defence Colony,
New Delhi - 110024
Phone: 011-45364506
Fax:    011- 45364507

Via e-mail

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Shiv Shakti
Mobile: 0 93127 22039