4th NATIONAL CONFERENCE 2024,

6th& 7th January

CHENNAI, TAMIL NADU
REGISTRATION FORm
Passport Size
40mmx35mm

PERSONAL INFORMATION

Name: …………………………………………………………………………………

Postal Address: .............................................................................................................................................................

……………………………………………………………………………………………………………………………………………………………………………….....

…………………………………………………………………………………………………………………………………………………………………………………..
CRR No.: …………………………………………………………………………………………………….

Telephone.: ………………………………….. Mobile No.: …………………………………………….

E-mail: ……………………………………………………………………………………………………….

Nationality: ………………………………. D.O.B: ………………………….. Gender: ………………….

Member of Council/ Organisation/ Society/ Association: …………………………………………………...

Valid Registration Number (Only for IAAT): ……………………………………………………………….

PROFESSIONAL INFORMATION/ STUDENTS

Qualification: …………………………………………………………………………………………………

Organisation/ Institution: ……………………………………………………………………………………..

Designation: ………………………………………………………………………………………………….

Register as an IAAT Member/ Non IAAT Member/ Professional/ Individual/ Spouse/ Accompanied
person/ Corporate/ Institution/ NGO’s/ INGO’s/ Student/ Foreign Delegate

Mode of Payment: Bank Transfer/ UPI/ NEFT/ Cheque/ DD Amount Paid: Rs………………………

Date of Transaction:…………………………. Unique Transaction Number: ………………………...

For Indian Delegates the Registration & all other payments For UPI Transactions Please scan the QR code
please use the following Bank Account & payment can be INDIAN ASSOCIATION OF ASSISTIVE
made either by Cash/ Cheque/ DD/ RTGS/ NEFT TECHNOLOGISTS
Name of the Bank: HDFC Bank VARANASI TID: 62789663
Branch Address: Saket Nagar Colo Mochan Lanka, Varanasi
Account Name: 4th IAAT NC 2024 INDN ASS OF ASISTVE TEC
Account No. : 50100660875687
IFSC Code : HDFC0001465
IFSC Code-5th Digit is Numerical Zero

For any enquiry please send a mail to iaatnc2024@gmail.com or log on www.iaatnc2024.com