REGISTRATION FORM

Dr. B.K.Mishra
Organising Secretary
Email:bkmmishra@hotmail.com  
Mb No : 09936057008
Off No :  09415214254
Off Add :18-Hanuman Bagh, Allahabad-211002


Dr. B.K.Mishra

I am in receipt of the circular for the 23rd ICON meeting being organized by you on 24th-26th September, at Allahabad.

I will / will not be attending the meeting. My registration fees of Rs 500/ Rs 1,000 is enclosed.

I will make my own travel reservations as follows:

I will be arriving by flight/train no on (date) at hh:mm (arrival time).  

I will be leaving by flight/train no on (date) at hh:mm (departure time).  

I understand that local arrangements will be available to eligible active fully paid non industry ICON member whose registration reaches you on or before 31st December 2009

If I am an eligible ICON Member, I will receive travel grant equivalent to 50% of the super-apex airfare (between my city and Kolkata by the shortest route) only if I attend the full two day scientific program.

I will be accompanied by persons. The payment will be sent to you latest by .