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Advanced Semiconductor Packaging Workshop: 7 November, 2015 Indian Institute of Technology Ropar

This document is a registration form for the Advanced Semiconductor Packaging Workshop being held on November 7th, 2015 at the Indian Institute of Technology Ropar. It requests information such as name, affiliation, email, mobile number, academic qualifications, IEEE membership details, registration amount paid, date and mode of payment, and whether the registrant wishes to participate in the poster session. Instructions are provided to fill out the form completely, provide proof of payment, and submit the signed form and payment proof by email to the specified address to complete registration. Bank details are also listed for payment transfer.

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52 views1 page

Advanced Semiconductor Packaging Workshop: 7 November, 2015 Indian Institute of Technology Ropar

This document is a registration form for the Advanced Semiconductor Packaging Workshop being held on November 7th, 2015 at the Indian Institute of Technology Ropar. It requests information such as name, affiliation, email, mobile number, academic qualifications, IEEE membership details, registration amount paid, date and mode of payment, and whether the registrant wishes to participate in the poster session. Instructions are provided to fill out the form completely, provide proof of payment, and submit the signed form and payment proof by email to the specified address to complete registration. Bank details are also listed for payment transfer.

Uploaded by

ramnik20098676
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Advanced Semiconductor Packaging Workshop

7th November, 2015


Indian Institute of Technology Ropar

REGISTRATION FORM

(Please read the instructions carefully before filing this form)

Name
Affiliation
Email
Mobile number
Highest academic qualification
IEEE member YES NO
If YES, your IEEE member number
Registration amount Rs. 1000 Rs. 1500 Rs. 2000 Rs.
2500
Date of transfer
Mode of bank transfer Online Offline
(Attach the pay-in slip or any other proof of payment)
Would you like to participate in the YES NO
poster session? (Only for students)

(Signature)

Important instructions:

1. Please fill all the entries. CHECK appropriate boxes, wherever applicable.
2. Registration will be incomplete without proof of payment.
3. Scan the signed form along with proof of payment and email the same to: rohit@iitrpr.ac.in
4. You will receive registration confirmation within 2 working days.
5. In case of any questions, please contact us via email/phone.

Details of Bank Transfer:

1. Account name: IEEE Student Branch, IIT Ropar


2. Account number: 34615856451
3. Name of bank: State Bank of India
4. Branch: IIT Ropar
5. IFSC code: SBIN0013181
6. Branch code: 13181

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