RTORS 2017
REGISTRATION FORM

Name of Delegate
:
Gender
:
Nationality
:
Designation
:
Name of Institute / Organization
:
Address
:
Email
:
Phone
:
Mobile
:
Whether Presenting a Paper
:
Paper ID
:
Paper Title
:
Registration Category Till November 01, 2017
:
Registration Category After November 01, 2017
:
Accommodation Needed
:
If Accommodation Required, Select From
:
Accommodation Required for (In Number of Days)
:
From Date (Date format in DD/MM/YYYY)
Mode of Payment
:

BANK DETAILS
For Online Payment
NAME OF THE BANK
:
STATE BANK OF INDIA
BRANCH OFFICE 
:
IIT ROORKEE
ACCOUNT NAME
:

DEAN SRIC, Conference, Seminar & Symposium, IIT ROORKEE, (RTORS 2017)

ACCOUNT NO.
:
33136732957
BRANCH CODE
:
1069
IFSC CODE 
:
SBIN0001069
MICR CODE
:
247002094
     
NOTE:
1. Bank Draft in favour of Dean, SRIC, IIT Roorkee and payable at Roorkee
2. Please quote Transaction ID/ Reference No. / Bank Draft mentioning you name and paper ID in the Registration Form
3. Accommodation will be made available one strictly First-cum-First-served basis. Charges for accommodation may be paid on arrival
Details of Payment
Amount
:
Online Transaction ID / DD Number
:
Date
:

(Date Format DD/MM/YYYY)
Bank Name
:
Place
:
IFSC/SWIFT Code
: