REGISTRATION FORM
Name (Capital letters)..........................................................................................................................................
Designation...................................................................................Gender: Male.....................Female...........
Affiliation............................................................................................................................................................ ….
Address for correspondence................................................................................................................ ............. . …
.............................................State......................................................PIN...............................................................
Email ID:.............................................................. Phone No.......................................................................... ……
Paper Title & Paper code………………………………………………………………………………………….
Are you a
(i) IEEE member
Y
N
If yes, Membership No:……………………………………………………..
Accommodation required (will be provided by the organizing committee only to participants):
Y
N
If yes, duration of the stay with travel itinerary…………………………………………………………………………
Accommodation required for accompanying person (payment basis): Rs. 1800/- per room per night
Accommodation required for non-authors (attending): Rs. 1000/- per night
Registration Details
Registration category
Alumni
IEEE non-member
IEEE member
Student Authors (attach copy of ID card)
Non-authors (attending)
Students Authors from IIT Roorkee
Non-Authors from IIT Roorkee
Payment mode: Cash
(only for on the spot)
Fees (Rs)
5000
3000
2500
1500
1000
1000
500
Demand Draft
Account Transfer
Amount (in words)................................................................................................................................................. …..
Demand Draft Number………………………………………………….Dated………………………………………...
Bank…………………………………………………………………………….
Date:
Signature of the participant
Note: 1. Scanned copy of registration form with payment details should be send by mail to e-mail id: [email protected]
2. Last date for online registration is Feb 5, 2015 and in the case of demand draft, it should reach on/before Feb 5,
2015.
3. On the spot registration is also possible but accommodation will be provided as per availability and paper
will be considered only for POSTER PRESENTATION.
Payment Option:
1. Demand draft should be drawn in favor of "REGISTRAR, IIT ROORKEE" PAYABLE at ROORKEE. Backside of the
draft, mention your name, address and the name of the conference. Send the DD to the address: Prof. Dharmendra
Singh, Convenor RAECE2015, Dept. of Electronics and Communication Engineering, IIT Roorkee, Roorkee247667, Uttarakhand.
2.
Registration
Fee
can
also
be
paid
through
State
(https://www.onlinesbi.com/prelogin/icollecthome.htm?corpID=365641), by using
Bank
Conference ID: CONFR-29-ECD.
Link for Electronic Fund Transfer:
https://www.onlinesbi.com/prelogin/icollecthome.htm?corpID=365641
Step-1:
Check the box (last line) and Click to proceed
iCollect
link
Step-2:
Select Category as IIT Roorkee Conference
Step-3:
Fill the details as required and fill Conference Code: CONFR-29-ECD.