Online Registration Form for PLANNER 2012
Personal Information
Name of Participant :
* Last Name,First Name
Designation:
*
Organization:
*
Address:
*
City:
*
State:
*
Sex :
Select
Male
Female
*
E-mail:
*
Contact No:
*
Accommodation Required:
Select
Yes
No
*
Accompanying Person(s): No of persons
*
Demand Draft Details
Draft No:
*
Draft Date:
* DD/MM/YYYY
Amount:
*
Bank Name:
*
Branch Name:
*
Travel Schedule Details
Arrival Date & Time
Mode(Air/Train/Bus)
Return Date & Time
Mode(Air/Train/Bus)
Any Other Relevant Information :
Please enter below mention
Verification
Code
*
0MJ06M
Important Notes:
Kindly send the DD to "Dr Tamal Kumar Guha, Organising Secretery, PLANNER 2012
Librarian,Sikkim University
6th Mile, Samdur,Post: Tadong,Gangtok-737102" .