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    The document is a registration form for an international conference on carbon nanotechnology being held from December 15-17, 2010 at the Indian Institute of Technology Kanpur in India. It requests information such as the participant's name, organization, contact details, whether they will present a paper and its title, and details of the demand draft for registration fees made payable to CARBON10 at the State Bank of India.

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    The document is a registration form for an international conference on carbon nanotechnology being held from December 15-17, 2010 at the Indian Institute of Technology Kanpur in India. It requests information such as the participant's name, organization, contact details, whether they will present a paper and its title, and details of the demand draft for registration fees made payable to CARBON10 at the State Bank of India.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    Download as doc, pdf, or txt
    2 views1 page

    Registration Form

    Uploaded by

    zeevesh
    The document is a registration form for an international conference on carbon nanotechnology being held from December 15-17, 2010 at the Indian Institute of Technology Kanpur in India. It requests information such as the participant's name, organization, contact details, whether they will present a paper and its title, and details of the demand draft for registration fees made payable to CARBON10 at the State Bank of India.

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    of 1

    INTERNATIONAL CONFERENCE

    ON
    CARBON NANOTECHNOLOGY:
    POTENTIAL AND CHALLENGES

    Venue: Indian Institute of Technology Kanpur, December 15-17, 2010

    REGISTRATION FORM
    Affix your
    Name: ______________________________________
    photograph
    Designation: ________________________________

    Organization: ________________________________

    Address for Correspondence: ____________________

    ____________________________________________

    ____________________________________________

    Email: ______________________________________

    Fax: ________________________________________

    Phone(s): ____________________________________

    Presenting paper: Yes/No


    If presenting, title:
    ____________________________________________
    ____________________________________________
    ____________________________________________

    Details of enclosed Demand Draft:

    No._______ Dated: ________ Amount (Rs): _______


    Issuing Bank: ____________________

    All draft should be in favour of CARBON10, payable at State Bank of India, IIT-
    Kanpur branch, Kanpur –208016.

    Date Participant’s Signature

    Signature: Head of the Organization/Institution (for student participants


    only) with seal

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