REGISTRATION FORM

AICTE Sponsored

National Seminar
On
Challenges and Advances in
Die Design
17-18 January, 2014
Category: Academician/ professional/ corporate/ Industry delegate
Name:________________________________________________________________________
Institute/Organization:___________________________________________________________
Designation:___________________________________________________________________
Educational
Qualification:_________________________________________________________________
Experience in years: Teaching_______

Industry__________

Address:_____________________________________________________________________
Mobile No: __________________________________________________________________
Email:______________________________________________________________________
Whether your institute is approved by AICTE? Yes/No__________
Accommodation Requested: Yes/ No_________________
Enclosed is DD No.___________Dated__________for Rs. 300 drawn in favour of Sri Balaji
Shiksha Samiti payable at Jaipur.

Date:____________________

Signature: ________________

Please return the form with enclosures to: Department of Mechanical Engineering, Sri Balaji
College of Engineering and Technology, Benad Road, Jaipur-302013(Rajasthan).
E-mail: caddmech14@gmail.com