FORZA’10

DEPARTMENT OF ELECTRICAL AND ELECTRONICS ENGINEERING

SRI RAMAKRISHNA ENGINEERING COLLEGE
VATTAMALAIPALAYAM, N.G.G.O. COLONY – POST COIMBATORE-641 022.
PHONE: 0422 2460088, 2461588 FAX: 0422 2461089
College website: www.srec.ac.in
Email:srecforza@gmail.com, website: www.forza10.co.cc

REGISTRATION FORM
NAME :

GENDER :

COLLEGE NAME :

DEPARTMENT :

REGISTRATION MODE : IEEE MEMBER\NON IEEE MEMBER

IEEE MEMBERSHIP NO :

STATE & CITY :

E-MAIL ID :

PHONE NO. :

REGISTRATION FEE :
(refer table below)

ACCOMMODATION : Needed \ Not Needed

DD NO : DD Date:

BANK NAME :

STUDENT SIGNATURE PRINCIPAL\HOD

With date With seal
 Choose Your Registration fee from the table below:

Accommodation IEEE Member Non IEEE Member

Not Needed Rs. 250 Rs. 300
1 Day Reg fee + Acc = Rs. 350 Reg fee + Acc = Rs. 400
2 Days Reg fee + Acc = Rs. 450 Reg fee + Acc = Rs. 500

Reg fee = Registration fee for workshop

Acc = Accommodation Rs. 100 per day

1. Forza kit will be provided to all the participants who have registered.
2. Lunch will be provided for all participants.
3. Demand Draft should be taken in the name of

FORZA10, SREC
Payable at Coimbatore

4. Please fill the registration form above carefully and send it along with you Demand
Draft to the following address

Prof. S.P. Rajkumar

Convenor & Head of the Department
Department of Electrical and Electronics Engineering
SRI RAMAKRISHNA ENGINEERING COLLEGE
Vattamalaipalayam, N.G.G.O. Colony post
Coimbatore – 641 022