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    Pragyanam: Shah and Anchor Kutchhi Polytechnic

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    Amol Nagap
    This document appears to be a registration form for an international conference on computer and electronics engineering. It collects information such as author names, paper details, affiliation, payment method, and contact information. Registrants can select if they are presenting, and their category as industry, faculty, or student. Extra proceeding copies can also be purchased for additional payment.

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    © All Rights Reserved
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    Pragyanam: Shah and Anchor Kutchhi Polytechnic

    Uploaded by

    Amol Nagap
    16 views1 page
    This document appears to be a registration form for an international conference on computer and electronics engineering. It collects information such as author names, paper details, affiliation, payment method, and contact information. Registrants can select if they are presenting, and their category as industry, faculty, or student. Extra proceeding copies can also be purchased for additional payment.

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    mba

    Original Title

    Registration Form

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    This document appears to be a registration form for an international conference on computer and electronics engineering. It collects information such as author names, paper details, affiliation, payment method, and contact information. Registrants can select if they are presenting, and their category as industry, faculty, or student. Extra proceeding copies can also be purchased for additional payment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    16 views1 page

    Pragyanam: Shah and Anchor Kutchhi Polytechnic

    Uploaded by

    Amol Nagap
    This document appears to be a registration form for an international conference on computer and electronics engineering. It collects information such as author names, paper details, affiliation, payment method, and contact information. Registrants can select if they are presenting, and their category as industry, faculty, or student. Extra proceeding copies can also be purchased for additional payment.

    Copyright:

    © All Rights Reserved
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    SHAH AND ANCHOR KUTCHHI POLYTECHNIC

    PRAGYANAM
    INTERNATIONAL CONFERENCE ON RECENT
    TRENDS IN COMPUTER & ELECTRONICS ENGINEERING (ICRTCEE)

    Registration Form
    Author Name: _______________________________________________________________________________
    Surname First Name Middle Name

    Co-Author Name: _______________________________________________________________________________


    Surname First Name Middle Name

    Co-Author Name: _______________________________________________________________________________


    Surname First Name Middle Name

    Co-Author Name: _______________________________________________________________________________


    Surname First Name Middle Name

    Co-Author Name: _______________________________________________________________________________


    Surname First Name Middle Name

    Paper ID: ___________________


    Title of Paper: ___________________________________________________________________________________
    Category (Select any one): Industry Delegate Faculty Student
    No. of proceedings required: ________________ (Additional Rs.500 for each extra proceeding copy)
    Presenting: Yes No

    Affiliation Details:
    Name: __________________________________________________________________________________________

    Designation: ________________________________________ Contact No.________________________________


    Address: _________________________________________________________________________________________
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    Correspondent Authors Email: ______________________________________________
    Demand Draft Details Demand Draft Details(For extra proceeding)

    D.D. Number:_________________ Amount:________ D.D. Number:_________________ Amount:________

    Issuing Bank: ___________________________________ Issuing Bank: ___________________________________

    Date: ______________ Signature: ________________ Date: ______________ Signature: ________________

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