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REGISTRATION FORM
Name [Mr/Ms/Dr/Prof] * :
Designation & Institution * :
Address for Correspondence * :
Abstract Reference Number
( If Already Abstract Submitted )
:
Zip / Pincode * :
Telephone No. :
Mobile No.* :
Email ID * :
Are you a member of ELTAI? :
Registration Fee Paid :
DD Number * :
Dated (dd-mm-yyyy)* :
Drawn On Bank * :
( P.S.Participants to write the registration number,Full address and Email ID at the reverse of the DD before posting).
 
Note :
  1. Registration fee may also paid by transfer of amount to our Bank account, ELTAI S.B Account (No. 30870397943, State Bank of India, Branch Code No.2196.(Santhi Colony, Chennai).
  2. Details of such a transfer made should be communicated to eltai_india@yahoo.co.in