Indian Institute of Technology, Kharagpur

NAME                           :

DESIGNATION           :

ORGANISATION        :

MAILING ADDRESS  :

TELEPHONE     :                                                 FAX :

EMAIL               :

(Please tick appropriate boxes)

(on payment*, indicate choice)

Payment should be made in favour of "National Conference on Communications 99" by DD on a Nationalised bank at Kharagpur

PAYMENT DETAILS :

DD No. :                                              Bank Name   :

Dated     :                                             Amount          :

Date:                                                                                                                                   Signature of Applicant

*Approximate accommodation Charge : IGH : Rs. 150/-, AGH : Rs. 50/-, CEP : Rs. 85/- per day per person on double sharing basis. If the requested accommo- dation is exhausted, some other accommodation will be allotted.

This form may be coiped if required

Note:

Last date for Registration is 31.12.98. Please send your registration form and the draft to Prof. T. S. Lamba, E&ECE, IIT, Kharagpur - 721 302