Praveen Kapoor Registration-Form IPLC15
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March 17-18, 2015 Venue: India International Registration Form ame !in "loc# letters$: %r&'Mr&'Ms&'Mrs&'(ro)& ***(R+V +(..R************************ *****************************************************************/ender: **Male***** %esignation :*****%e ut i"rarian****************************************************** .rganisation:* 3ni4ersit o) (etroleum and nerg tudies, %ehradun ************************* +ddress:* nerg +cres, (&.& 6idholi Via-(rem agar, %ehradun-2 8007 ************************ (incode: ***2 8007************** tate: ***3ttara#hand************* Countr :******India************** (hone: % Code ****************** .9ce:******************* Res& 1- 7 ;88855 * Fa<: *********************** ***** Mo"ile: * 1- 87551 8877 ************************ mail: * #a oor=ddn&u es&ac&in *************************************************** (a ment %etails: I am enclosing the artici ation )ee o) Rs 1500 )or I( 2015 " %emand %ra)t' Che>ue o ********************************************************************** %ated **************************************, dra?n on @ %igital m o?erment FoundationA, (a a"le at e? %elhi& Post conference workshops and study tour will be organised on March 19, 2015. Interested delegates ay write for registration! con"ration to Ms #aita Mon $ao at naita%de"ndia.net or call at 9&9 919 90'9.
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Transcript of Praveen Kapoor Registration-Form IPLC15
Registration FormName (in block letters): Dr./Mr./Ms./Mrs./Prof. ___PRAVEEN KAPOOR________________________ _________________________________________________________________Gender: __Male_____Designation :_____Deputy Librarian______________________________________________________Organisation:_ University of Petroleum and Energy Studies, Dehradun _________________________ Address:_ Energy Acres, P.O. Bidholi Via-Prem Nagar, Dehradun-248007 ________________________Pincode: ___248007______________ State: ___Uttarakhand_____________ Country:______India______________Phone: STD Code __________________ Office:___________________ Res. 91-9793888559_ Fax: _______________________ _____ Mobile: _91-8755148877________________________ Email: [email protected]_______________________________________________________
Payment Details: I am enclosing the participation fee of Rs 1500 for IPLC 2015 by Demand Draft/ Cheque No ______________________________________________________________________
Dated ______________________________________, drawn on Digital Empowerment Foundation,
Payable at New Delhi.
Post conference workshops and study tour will be organised on March 19, 2015.
Interested delegates may write for registration/ confirmation to Ms Namita Monga Rao at [email protected] or call at 989 919 9049.
Place : ______________________ Date: ___________________________
March 17-18, 2015
Venue: India International Centre
40 Lodhi Estate, New Delhi, India
