rd TH

3 CRIKC NANOSCIENCE DAY 29 AUGUST, 2017

Jointly organized by CSIR-CSIO, Chandigarh and INST, Mohali
To be held at CSIR-Central Scientific Instruments Organization
Sector 30-C, Chandigarh-160030

REGISTRATION FORM

NAME: ___MANISH KUMAR MOHANTA___

DESIGNATION: _______Ph.D________________________________________

AFFILIATION: ____INSTITUTE OF NANO SCIENCE AND TECHNOLOGY____

ADDRESS: __SECTOR 64, PHASE 10, MOHALI, PUNJAB, 160062__

______________________________________________________________

EMAIL: ___manishkmr484@gmail.com___

PHONE NO. _____9643212837______

RESGISTRATION DETAILS:
Date of Registration: ____17-08-2017_____
Registration Fee:
Amount: ____300_____
Mode of payment: Bank Transfer
Bank transfer reference no. ___IHF0314838___

(SIGNATURE)

Scanned copy of duly filled registration form and DD may be emailed to

crikcnanocsio@gmail.com