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REGISTRATION FORM

Name: Vaibhav Pandurang Choudhari


Qualification: M.Tech (IV Sem)

Designation:PG Student

Paper ID: _________________________________ Track: ________________________________________


Paper Title: IEEE 802.15.4 for Intelligent Transport System Application
Organization: Priyadarshini College of Engineering, Nagpur
Address: Hingna T-Point Nagpur
Phone/Mobile8087955809

Fax: __________________________________

E-mail ID:vchoudhari8@gmail.com
Participant Category:
PG Research Scholar

PhD Research Scholar

Non-Author Delegate

Others

Accommodation required: Yes/No, if yes we will provide assistance for accommodation.

Registration Details:
Payment Mode:

Cash

DD

Cash Amount:
DD Details:
DD Amount: ...
DD No.: ......
Drawn Bank: ...
Dated: .......

NEFT/RTGS

NEFT/RTGS:

Amount:
Transaction ID: .
Name of Bank: ..
IFSC Code: ..
Dated: ................

Kindly indicate your name and Paper ID at the back of the bank Demand Draft.
Signature of the Applicant: ____________________________
Date: _____________________

Place: _______________________

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