REGISTRATION

Registration for the one day workshop can be done by submitting the registration form through E-mail on or before 18 th Jan 2011
mentioning the DD No, bank & date.

Students : Rs.200
Member IEEE & IETE : Rs.400
Faculty : Rs.500
Industry : Rs.2000

Name:
Designation:
Organization:

Please Tick in appropriate box

Delegate from Industries, R& D, Govt.

Faculty

Students
Member IEEE & IETE etc.
Membership No:
Telephone: Off: Res:
Fax:
Mobile:

Registration Fee Rs:

DD Drawn on:

Demand Draft No:

In favour of Principal, VRSEC, payble at Vijayawada

Bank & Branch:

Date: Place: Signature