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Please mail the mode of payment along with details immediately for our convenience to etdab2019@gmail.com

Contact: 9422095481, 9423153402

ETDAB 2019 National Conference Deogiri College, Aurangabad.MS

REGISTRATION FORM

Name (Block letters)…………………………………………………………………………………………………………………………

Designation:………………………………Affiliation/Institute………………………………………………………………………..

Postal Address…………………………………………………………………………………………………………………………………

Paper Title (Oral/Poster)………………………………………………………………………………………………………………...........

………………………………………………………………………………………………………Theme……………………………………...

Mobile: ……………………………… Email ...……………………………………………...…………………………………………….

Payment Details:

1. Bank draft (payable at Aurangabad in favor of Principal, Deogiri College, Aurangabad)

Draft No………………………………………………….Amount…………………… Date / / 2019

Name of the Bank …….…………………………………………………………………...……………………………………………

2. Online transfer details:

Reference No/UTR. …………………………… Date / / 2019

Name of the Bank ...……………………………………………………………………………………Debit /Credit Card

Date: Signature of Participant

Name :

HDFC Bank Details Account Name Principal, Deogiri College,

Aurangabad. Bank Ac No 50200032287344 IFSC Code HDFC0001453

Branch Kalda Corner, Aurangabad.

*Early bird registration fees will be accepted only before 15th Dec 2019.