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    5 International Symposium On Electronic System Design: (ISED 2014)

    Uploaded by

    Keith Fernandes
    The document is a registration form for the 5th International Symposium on Electronic System Design (ISED 2014) being held from December 15-17, 2014 at the National Institute of Technology Karnataka in Surathkal, Mangalore, India. It requests the attendee's name, company/affiliation, address, contact details, and IEEE membership information. It outlines the early and late registration fees in Indian Rupees and US Dollars for industry, academic, and student attendees depending on their IEEE membership status and registration date. Payment details are also requested.

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    © All Rights Reserved
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    5 International Symposium On Electronic System Design: (ISED 2014)

    Uploaded by

    Keith Fernandes
    33 views2 pages
    The document is a registration form for the 5th International Symposium on Electronic System Design (ISED 2014) being held from December 15-17, 2014 at the National Institute of Technology Karnataka in Surathkal, Mangalore, India. It requests the attendee's name, company/affiliation, address, contact details, and IEEE membership information. It outlines the early and late registration fees in Indian Rupees and US Dollars for industry, academic, and student attendees depending on their IEEE membership status and registration date. Payment details are also requested.

    Original Description:

    ISED14 NITK Surtahkal

    Original Title

    Registration ISED14

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    The document is a registration form for the 5th International Symposium on Electronic System Design (ISED 2014) being held from December 15-17, 2014 at the National Institute of Technology Karnataka in Surathkal, Mangalore, India. It requests the attendee's name, company/affiliation, address, contact details, and IEEE membership information. It outlines the early and late registration fees in Indian Rupees and US Dollars for industry, academic, and student attendees depending on their IEEE membership status and registration date. Payment details are also requested.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    33 views2 pages

    5 International Symposium On Electronic System Design: (ISED 2014)

    Uploaded by

    Keith Fernandes
    The document is a registration form for the 5th International Symposium on Electronic System Design (ISED 2014) being held from December 15-17, 2014 at the National Institute of Technology Karnataka in Surathkal, Mangalore, India. It requests the attendee's name, company/affiliation, address, contact details, and IEEE membership information. It outlines the early and late registration fees in Indian Rupees and US Dollars for industry, academic, and student attendees depending on their IEEE membership status and registration date. Payment details are also requested.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
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    5th International Symposium on Electronic System Design

    (ISED 2014)
    December 15 - 17, 2014
    National Institute of Technology Karnataka, Surathkal, Mangalore, India
    REGISTRATION FORM FOR DELEGATES

    Name:
    Mr./Ms./Dr./Prof.:____________________________________________________________________
    _________
    Company/Affiliation:
    __________________________________________________________________________________
    Address:
    ___________________________________________________________________________________
    _____________

    City: ___________________ Country: _____________________Postal Code:


    _____________________________________
    Mobile:
    ______________________________Email:_______________________________________________
    ________________
    Foreign Delegates
    Passport No. ___________________ Date of issue: ______________ Place of issue:
    ______________________________
    Date of expiry: ________________________ Nationality: ________________
    Category (tick [
    ________

    ]): Academia [

    ] Industry [ ] Student [ ]; IEEE Membership No.:

    Registration Fees (tick [


    ] the amount applicable):
    Early Bid Registration (Registration on or Before 15th Oct 2014
    IEEE Member

    Non - IEEE Member

    India (in INR)

    Outside (in USD)

    India (in INR)

    Outside (in USD)

    Industry

    12000

    300

    15000

    350

    Academic

    7000

    200

    8000

    250

    Student

    4000

    150

    5000

    180

    Late Registration (Registration After 15th Oct 2014)


    IEEE Member

    Non - IEEE Member

    India (in INR)

    Outside (in USD)

    India (in INR)

    Outside (in USD)

    Industry

    14000

    350

    16000

    400

    Academic

    8000

    250

    9000

    300

    Student

    5000

    180

    6000

    200

    Each extra page charge (INR 1,500.00 / USD 30per page)


    ___________________________________________
    Total Amount (Registration + Extra page charge) INR/USD
    _______________________________________

    Paper ID: . Title:Payments made through Cheque/ Demand Draft (Indian Delegates)
    Cheque/Draft No: ______________ Dated:_______________ Drawn on (Bank Name):
    _______________________
    Date: ______________
    _____________________________

    Signature:

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