Registration cum Accommodation Form


 
  Name :
 
  Title/Degree:  
  Gender:   Male Female
  Institute/Organisation :  
  Department/Division :  
  Address :  
  Country :         

  Postal Code :  
  City :  
   E-Mail :   
  Telephone with country code and city-code or Mobile No :    
  ACCOMODATION DETAILS: (At Hotel Toshali sands,Puri,India)  
  No. of accompanying person :  
  Check in (Date) :
 
  Check out (Date) :
 
  Period of stay :   days.
N.B : Amounts are to be written in US Dollar(USD) or Indian Rupees(INR).
  Registration fee to be paid :
     Registration fees details
  Accomodation charges to be paid :
     Accommodation charges details
  Total amount :
 

PAYMENT DETAILS:

Notes:
(1) Alottment of single rooms would be on first-cum-first basis. Accommodation request should reach us at the earliest.
(2) The invited speakers are requested to fill the completed registration and accommodation form. Contact us (psi2009@iopb.res.in) for any clarifications.
(3) Tentative registartion maybe done by other prospective participants. Payment should be done only after receiving the acceptance of their paper(s). For details on spouse/accommpanysing person registration, please contact the convener (P V Satyam).


FOR PARTICIPANTS FROM ABROAD :
The total charge (Registration fees + Accomodation charges) has to be sent to INDIAN OVERSEAS BANK, Branch code: 1476, Saving bank A/C No: 15801, A/C Name: PSI2009, SWIFT CODE: IOBAINBB159.

FOR PARTICIPANTS FROM INDIA:
Indian participants need to send a BANK DRAFT in favour of PSI2009, Account No: 15801 payble at Bhubaneswar.
DEMAND DRAFT:
  Demand Draft No :
 
  Dated :
 

  ANY OTHER INFORMATION:  


        
       
Last date of Registration : December 31, 2008