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CALENDAR 2012-13 APPLICATION FORMAT FOR ATTENDING CALENDAR PROGRAMME Participant Details Name Designation/Discipline Name of the Institute/Organization

with full Postal Address Govt. Govt. Aided/Self-Financed (Private) - Please tick one Engineering College/Polytechnic/Other ( Please tick or specify) Sponsoring Agency Contact details Phone No./Fax No./E-mail/Mobile Phone No. Programme Details Name of the Programme & Programme Code no Duration Name of the Coordinator/faculty Signature of Participant Signature & Seal of Sponsoring Authority (O) (R) (M) E-mail

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