Registration Form - Jrnrvu

JANARDAN RAI NAGAR RAJASTHAN VIDYAPEETH UNIVERSITY
(Established Under Section 3 of the UGC Act, 1956 vide Notification No. F.9-5/84-U-3, January 12, 1987 of the Government of India)
LOKMANYA TILAK TEACHERS TRAINING COLLEGE
DABOK-313022,UDAIPUR (RAJ.)
(“A” Graded by National Assessment and Accreditation Council)
International Conference on
Promoting Social Cohesion Through Peace Education
25 th to 27 th March,2011
Registration Form
Name : ……………………………………………………………………….……………………………
Designation : …………………………………………………………..…………………………………..
Organization and its Address :……………………………………………………..…………………….
…………………………………………………………………………………………………………………
Mailing Address :……………………………………………………………………………………………
Phone No. (O)………………………………(R)…………….……….…..(M)…………..………………..
e-mail………………………………………………………………………………………………………..
I wish to participate as –
Accommodation Required –
Indian Delegate
Yes
Required Special Accommodations : (On self Finance Basis)
Yes
Foreign Delegate
No
No
Presenting paper Yes No
If yes, Title of the Paper
…………………………………………………………………………………………………………………
…………………………………………………………………………………….………………………….
Please Tick the sub theme on which of the Paper is being presented.
A B C D E F
Registration Fee Amount of Rs./$...........................................................................is sent
by DD…………………………………………………………………………..…………………
Dated…………………………on (Name of Bank)……..……………………………….………
Cash Amount ……………………………………………………. Receipt No. …………......
Place : ……………………..……….
Date :………………………….……
Signature