International Conference on Bridging and Securing: the International Conference on Bridging and Securing: the

Responsibilities and Aesthetics in Media, Society and Literature Responsibilities and Aesthetics in Media, Society and Literature
Organized By Organized By
Dept. of Social Work and English (M&J) Dept. of Social Work and English (M&J)
Kodaikanal Christian College. Kodaikanal Kodaikanal Christian College. Kodaikanal
on 11th September - 2018 on 11th September - 2018

REGISTRATION FORM REGISTRATION FORM

Name: Mr / Ms / Mrs / Dr._______________________________________________________________ Name: Mr / Ms / Mrs / Dr._______________________________________________________________

Designation: a) Student ( ) b) Scholars ( ) c) Faculty ( ) d) Practitioner ( ) Designation: a) Student ( ) b) Scholars ( ) c) Faculty ( ) d) Practitioner ( )

Name of the Institution (Address:) ________________________________________________________ Name of the Institution (Address:) ________________________________________________________

__________________________________________________________________________________ __________________________________________________________________________________

Mobile:_____________________E-mail: ________________________________________________ Mobile:_____________________E-mail: ________________________________________________

Title ________________________________________________________________________________ Title ________________________________________________________________________________

_____________________________________________________________________________________ _____________________________________________________________________________________

Participation ( ) / Paper Presentation ( ) / Poster Presentation ( ) / Street play ( ) / Drawing ( ) / Participation ( ) / Paper Presentation ( ) / Poster Presentation ( ) / Street play ( ) / Drawing ( ) /

Short film ( ) / Photography ( ) / Slogan Writing ( ) / Painting ( ) Short film ( ) / Photography ( ) / Slogan Writing ( ) / Painting ( )

Paper to be published in ISSN: Yes ( ) No ( ) Paper to be published in ISSN: Yes ( ) No ( )

Registration Fee Details: Registration Fee Details:

Registration Fees DD Number Date of Issue Issuing Bank Registration Fees DD Number Date of Issue Issuing Bank

DD in favour of “The Principal, Kodaikanal Christian College” payable at Kodaikanal DD in favour of “The Principal, Kodaikanal Christian College” payable at Kodaikanal

NEFT: Central Bank of India, Kodaikanal, Acc. No. : 2307655832, CBIN 0284057 NEFT: Central Bank of India, Kodaikanal, Acc. No. : 2307655832, CBIN 0284057
(after transferring the Amount , please inform the transaction ID to us to check with bank) (after transferring the Amount , please inform the transaction ID to us to check with bank)

Photocopy can be used Signature of the participant Photocopy can be used Signature of the participant