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Multidisciplinary International Conference on "INNOVATIVE IDEAS IN THE FIELDS OF SCIENCE, SOCIAL SCIENCES AND MANAGEMENT” Organized by : Shri Jagdish Prasad Jhabarmal Tibrewala University in association with : J. Watumull Sadhubella Girls College, Ulhasnagar (M.S.) India and International Cultural Forum, Mauritius in jointly Collaboration with : Udayana University Bali, Indonesia MAY 19-24, 2018 REGISTRATION FORM Prof./Dr. / Mr. / Ms. .......................................................... ......................................................... Name : ....................................................... .............................................................. ................... (Surname) (First Name) (Middle Name) Designation : ................................................ .............................................................. ................ Organization : ............................................... .............................................................. ................ Address : .................................................... .............................................................. ...................

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Multidisciplinary International Conference on"INNOVATIVE IDEAS IN THE FIELDS OF SCIENCE, SOCIAL SCIENCES AND MANAGEMENT”

Organized by : Shri Jagdish Prasad Jhabarmal Tibrewala Universityin association with : J. Watumull Sadhubella Girls College, Ulhasnagar (M.S.) India and

International Cultural Forum, Mauritius in jointly Collaboration with : Udayana University Bali, Indonesia

MAY 19-24, 2018

REGISTRATION FORM

Prof./Dr. / Mr. / Ms. ...................................................................................................................

Name : ........................................................................................................................................

(Surname) (First Name) (Middle Name)

Designation : ..............................................................................................................................

Organization : .............................................................................................................................

Address : .....................................................................................................................................

....................................................................................................................................................

Country : .................................................. PIN/Zip code :...........................................................

Email : .........................................................................................................................................

Contact (M) : .................................................. (R)......................................................................

Whether submitting abstract Yes/ No for Oral /Poster

Title of the Paper : ......................................................................................................................

....................................................................................................................................................

Payment Mode: DD / Bank Transfer through RTGS/NEFT

D.D. No/UTR No. ......................................................... Date : ...................................................

Drawee Bank :.......................................................... Amount Rs. : ...........................................

Passport Details/ID Proof : .........................................................................................................

BANK DETAILS AND ACCOUNT NUMBER : SignatureBank Name: Bank of BarodaAccount Name : Crossways Tours & TravelsAccount No: 04240200007559IFSC Code: BARBOTHANAXMICR Code: 400012079Bank address: Annapurna,Gokhale Road,Naupada,Thane (W),Phone: 022-25422714