form a day1 registration

1
DHIRAJLAL GANDHI COLLEGE OF TECHNOLOGY (Approved by AICTE, NEW DELHI & Affiliated to ANNA UNIVERSITY, CHENNAI) Opposite Salem Airport | Sikkanampatty | Omalur | Salem-636309. National Conference on Engineering Applications for Developing Smart Cities (NCEADS) DAY 1 REGISTRATION FORM (FORM A) Paper / Poster Presentation Candidate Name & Registration No. Department Date of Birth & Year/Section Category (Tick Appropriate) Research Scholars Faculty Industrialists UG PG Scientists Gender Female Male Institution Name & Address with Pin code Contact Name Phone Number E-mail Alternate E-mail Title of the Paper Paper ID Registration Type (Tick Appropriate) Early Bird/Normal Names & Affiliation of Authors Number of Registered Authors & Names Transaction No. Bank Name & Branch Name Transaction Date Amount (Rs.) Hard Copy of Proceedings (Rs.500 Extra to be Paid along with Registration) Required Not Required Signature of the Participant Note: Send Scanned copy of Form A, Copy Right, Originality form & Payment Challan to [email protected] and bring Originals at the time of Conference. Each Participant/ author must register individually. Only registered Participant/Author receives Kit, Materials and Certificates. Students without Valid College ID card will not be permitted. Judges decision will be final and binding for all the events.

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Page 1: Form a Day1 Registration

DHIRAJLAL GANDHI COLLEGE OF TECHNOLOGY (Approved by AICTE, NEW DELHI & Affiliated to ANNA UNIVERSITY, CHENNAI)

Opposite Salem Airport | Sikkanampatty | Omalur | Salem-636309.

National Conference on Engineering Applications for Developing Smart Cities (NCEADS)

DAY 1 REGISTRATION FORM (FORM A) Paper / Poster Presentation

Candidate Name & Registration No. Department

Date of Birth & Year/Section

Category (Tick Appropriate)

Research Scholars Faculty Industrialists

UG PG Scientists

Gender Female Male

Institution Name & Address

with Pin code

Contact Name

Phone Number

E-mail

Alternate E-mail

Title of the Paper

Paper ID Registration Type

(Tick Appropriate)

Early Bird/Normal

Names & Affiliation of Authors Number of Registered Authors & Names

Transaction No. Bank Name & Branch Name

Transaction Date Amount (Rs.)

Hard Copy of Proceedings (Rs.500 Extra to be Paid along with Registration)

Required Not Required

Signature of the Participant

Note: Send Scanned copy of Form A, Copy Right, Originality form & Payment Challan to [email protected]

and bring Originals at the time of Conference. Each Participant/ author must register individually. Only registered Participant/Author receives Kit, Materials and Certificates. Students without Valid College ID card will not be permitted. Judges decision will be final and binding for all the events.