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Museums Association of India


All India Museums Conference
At Bhubaneswar 15th to 17th January, 2011
Venue: Regional Museum of Natural History, Bhubaneswar (Orissa)

CONFIRMATION OF PARTICIPATION

Name _________________________________________________________________
Designation : _________________________________________________________________
Contact Address _________________________________________________ Pin:____________
Tel./Email : _________________________________________________________________

Arrival at Bhubaneswar : by Air/Rail/Bus: ________ Date: ____________ Time: ___________


Departure from Bhubaneswar : by Air/Rail/Bus: ________ Date: ____________ Time: ___________
Whether attending Conference : Single/with spouse ________________

Whether presenting paper : Yes/No


If accompanied by spouse, the required expenses will be borne by me.

Signature: _______________
_____________________________________________________________________________________
To: Mrs. Naaz Rizvi, Scientist ‘D’, National Museum of Natural History,FICCI Museum Building,
Barakhamba Road, New Delhi-110001. Tel.09868244086/naazrizvi@yahoo.com
____________________________________________________________________________________

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