International Conference on Multidisciplinary Research & Practice (ICMRP-2014) 30th November 2014 At Ahmedabad Management Association, ATIRA Campus, IIM-A Road, Ahmedabad, Gujarat, India www.rsisinternational.org by Research and Scientific Innovation Society Australia ǀ Thailand ǀ India REGISTRATION FORM Name of Delegate: ................................................................................................................................... Gender: Male/Female............................... Designation: ..................................................................... Name & Address of the Institution/Organization: ............................................................................ .................................................................................................................................................................. .................................................................................................................................................................. Address for Communication: ................................................................................................................... City: ........................................................ Pin: ......................................................... State: ............................................ Telephone Number: (O)............................... (R)............................... (Mobile)......................................... Email Id: ................................................................................................................................................... Title of the Paper: .................................................................................................................................... Details of Registration Fees: Please tick one of the following to choose Registration Type Indian Academicians Industry Virtual-Presentation Listener ₹ 2300 ₹ 3000 ₹ 2500 ₹ 1500 Foreigner US US US US $100 $135 $110 $50 Account Details: Account Name Account Number Account Type Bank Name Branch Code IFSC Code MICR Code RESEARCH AND SCI INNOVATION SOCIETY 661401700105 Saving Bank A/C ICICI Bank Ltd., Central Arcade, DLF City, Phase-II, Gurgaon,India 006614 ICIC0006614 110229182 Mode of Payment: Please tick one of the following to choose    DD Online Transfer Cash DD Number: ....................................... Transaction ID: ................................... Are You Presenting a Paper (Yes/No): __________________ • If No: The Delegates Should Clearly Indicate If Presenting Paper through virtual presentation. • The Delegates Non-Presenting a Paper in both modes will register earlier, we need to be sure that we have Enough Seats Available for Presentations. Signature of the Delegate Date: Place: All authors (or one of the authors authorized by others) should sign it and mail it to the following address immediately: - [email protected] COPYRIGHT TRANSFER FORM This is to verify that my/our article: Title of the Article: __________________________________________________________________________ __________________________________________________________________________ Authors: _____________________________________________________________ Submission: _________________Dated: _____________________ By submitting my/our article, we understand that I/we had transferred the copyright of this article to ICMRP 2014. The copyright transfer covers all rights to referee, translate, to reproduce and distribute the article, including reprints, photographic reproduction, microform or any other reproductions similar nature. This copy is to re-confirm my/our copyright transfer and to re-confirm that it is my/our original work, and has not been published elsewhere and will not be submitted anywhere else for publication. _____________________ ____________________ _______________________ Signature of Author-1/Date Signature of Author-2/Date Signature of Author-3/Date Corresponding Authors contact details with email and phone number: A) B) C)