REGISTRATION FORM National Conference

on

ANALYTICAL TECHNIQUES AND THEIR APPLICATIONS (NCATA-2017)

March 16-17, 2017 Dr. A. P. J. Abdul Kalam Central Instrumentation Laboratory

Guru Jambheshwar University of Science and Technology Hisar-125001, Haryana

Name______________________________________________________________________ Designation_________________________________________________________________ Affiliation__________________________________________________________________ Address____________________________________________________________________ ___________________________________________________________________________ Mobile_____________________________________________________________________ E-mail_____________________________________________________________________ Title of the paper_____________________________________________________________ ___________________________________________________________________________ Mode of presentation (oral/poster/attend)__________________________________________ Registration fee Payment detail _________________________________________________ Amount____________________________________________________________________ Transaction ID/DD No _________________________________ Date __________________ Accompanying person(s) ______________________________________________________ Whether accommodation required? Yes/No________________________________________

Place: Date: Signature

All Correspondence should be addressed to Prof. Devinder Kumar Dr. Vikas Verma Convener, NCATA-2017 Organizing Secretary, NCATA-2017 Tel.: 01662-263352, 263358 Tel.: 01662-263152, 263542; Mob.: 9416588307 Mob. : 9416499178

Dr. A.P.J. Abdul Kalam Central Instrumentation Laboratory Guru Jambheshwar University of Science & Technology, Hisar-125001, Haryana

E-mail: ncata2017@gmail.com