CONFERENCE REGISTRATION FORM A Registered Participant will receive the Conference kit, is entitled to attend all the Conference sessions, and also to join the Conference speakers for the afternoon lunch, and refreshments. For clarifications write to [email protected] Website: http://niasconsciousnesscentre.com/Conf-2015/a/index.html If you would need info on lodges and hotels in the neighbourhood of NIAS for accommodation, discounted prices, and other logistic details, do write to [email protected] _______________________________________________________________ Registration Fee: For India and SAARC Countries – INR Rs.3000/For Developing Countries - USD 100/Other Countries - USD 200/For Students from India – INR Rs. 1000/For Students from Developing Countries - USD 50/For Students from Other Countries - USD 100/For Corporates – INR Rs. 5000/_______________________________________________________________ Registration for Participants from other countries (Online Transfer Applicable Only for Foreign Participants) Below are the details for online transfer of foreign currency funds Beneficiary Name: National Institute of Advanced Studies Beneficiary A/c No: 10270575077 Bank With: State Bank of India, IISc Branch, Bengaluru, INDIA Branch Code No: 02215 SWIFT CODE NO: SBININBB425 IFS Code: SBIN0002215 After making the Online Transfer please send us the filled registration form with details of the online transfer. _______________________________________________________________ 1 _______________________________________________________________ Registration for Participants from India The payment option could be by DD or Cheque payable at par. Please send by post the DD or Cheque taken in the name of NATIONAL INSTITUTE OF ADVANCED STUDIES, along with the completed registration form, to the address below. _______________________________________________________________ Mr. P. Srinivasa Aithal Head, Administration & Finance National Institute of Advanced Studies Indian Institute of Science campus, Bengaluru 560012 Email [email protected] PLEASE FILL IN THIS FORM COMPLETELY, AND SEND BY POST TO THE ABOVE ADDRESS ALONG WITH THE CHEQUE OR DEMAND DRAFT * Required Name * Address * Postal/Zip code * City * Telephone/Mobile * Email * Please state a few lines about your interest in this Conference * 2 Are you interested in submitting a Poster abstract? Those interested to present a Poster at the conference may send an Abstract (~500 words) and Title latest by 1 September 2015 to the Email address [email protected]. Submissions will go through a review process and selected presenters will be informed by 1st October 2015. And the Conference registration fee will be waived for the selected poster presenters. Mode of submission of Registration fee * by Demand Draft (for participants from India) by Cheque (for participants from India) by Online transfer of foreign currency Write the details of the Cheque or Demand Draft such as Cheque/DD No, Date and Bank details. Indian Participants to draw the Cheque/DD in favour of NATIONAL INSTITUTE OF ADVANCED STUDIES, payable at Bengaluru. Please write the DD/Cheque No. ; Dated; Drawn on; Bank; Branch, and Place Write the details of FC online transfer Participants from Other Countries may pay the Registration Fee by Online transfer as below, or in person on arrival: Beneficiary Name: NATIONAL INSTITUTE OF ADVANCED STUDIES Bank Name: State Bank of India, Indian Institute of Science (IISc) Branch, Bangalore 560 012 A/C No. 10270575077; Swift Code: SBININBB425; Branch Code: 02215 Registration Fee Amount Paid * 3 Choose category * Student Teacher Professional Corporate Other: Any other info you wish to share PLEASE FILL IN THIS FORM COMPLETELY, AND SEND BY POST TO THE BELOW ADDRESS ALONG WITH THE CHEQUE OR DEMAND DRAFT Mr. P. Srinivasa Aithal Head, Administration & Finance National Institute of Advanced Studies Indian Institute of Science campus, Bengaluru 560012 ------------------------------------------------------------------------------------------------------------------------Any Questions, write to [email protected] or Call Ms V Girija, Conference Office – 080-22185025 ------------------------------------------------------------------------------------------------------------------------- 4
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