Department of Electronics and IT

Ministry of Communications and IT

Government of India

5th ASSOCHAM International Conference

CYBER & NETWORK SECURITY
Thursday, 10th May 2012 Hotel Le Meridien, New Delhi

Registration Options

Delegate 1 Delegate 2 Delegate 3

Name

Designation

Organization

Address

Tel #
Fax #
Email- id

Delegate registration Fees:

Rs. 4,000/- per delegate. (20% discount for 2 or more delegates)

A cheque/demand draft of Rs. ___________ (No. ______________ dated drawn on

__________________________) being participation fee per person in favour of ASSOCHAM, New Delhi is enclosed.

__________________________________ ______________
Name & Designation of nominating authority (Signature)

REGISTRATION OPTIONS:

Names
By Fax: By Email:
By Phone:

Mr. Ajeet Srivastava 01 1 - 46 53 64 81 / ajeet.srivastava@assocham.com 93 50 42 32 0 3

01 1 - 46 53 64 82 /
Mr. Sanjeev Dogra 01 1 - 46 53 64 98 icedivision@assocham.com 7 82 77 57 7 41