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Iciaia Reg Form

This document is a registration form for the IEEE CIS - Intel AI Academy One Day Workshop on July 13, 2018 in Kolkata, India. It collects contact information such as name, gender, qualifications, organization, areas of interest, address, phone numbers, and email from applicants. There is no registration fee and the deadline to apply is July 3, 2018.

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gemkousk
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66 views1 page

Iciaia Reg Form

This document is a registration form for the IEEE CIS - Intel AI Academy One Day Workshop on July 13, 2018 in Kolkata, India. It collects contact information such as name, gender, qualifications, organization, areas of interest, address, phone numbers, and email from applicants. There is no registration fee and the deadline to apply is July 3, 2018.

Uploaded by

gemkousk
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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ICIAIA’18

IEEE CIS — Intel AI Academy One Day Workshop


Date: July 13, 2018
Jointly organized by
Intel and IEEE CIS Kolkata Chapter
hosted at
Machine Intelligence Unit
Indian Statistical Institute,
203 B. T. Road, Kolkata 700108, India
Application / Registration Form
Workshop Registration is FREE for all the participants
Last date for Application: 3 July, 2018

NAME (in block letters) : KOUSHIK MONDAL


Male / Female : MALE
Highest Qualification : Ph.D
Institute / Organization : IIT (ISM) Dhanbad
Designation : System Manager
Areas of Interest : Data Science, Big Data
Correspondence Address : Computer Centre, IIT (ISM) Dhanbad

Telephone Number : 03262235628


Mobile Number : 8889942226
Fax Number (if any) :
E-mail : gemkousk@gmail.com
Food Habit : Non-veg
Recommendation of Head of Institution / Department (for Students only)

The applicant is a bona fide research scholar /student of my institution.

Signature of the Head/Supervisor (with seal) Signature of the applicant


A scanned copy of filled application may be e-mailed to: iciaia18@isical.ac.in
(Note: There is no provision for Accommodation for the participants.)

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