International Workshop on Seismo-Electromagnetics and Atmospheric Science (IWSE-AS 2010),

16 – 18 November 2010, Agra (India)
Registration Form

(The participants are required to send completed registration form up to 28th February, 2010)

Name   :
Date of Birth   :
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:
Nationality   :
Affiliation   :
Position   :
Address   :
TEL(including Country code)   :
FAX(including Country code)   :
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Presenting a Paper   : Yes  ( )  Oral ( )  Poster ( )  No ( )  
Title of the paper   :
Additional information, if any   :
No. of accompanying person   :
Excursion on 19 November   : Yes ( )  No ( )
Accommodation Required   : Yes ( )  No ( )  Budget ...................................
     
     
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Please mail to the convener :

Dr. O.P. Singh
Department of Physics,
Faculty of Engineering and Technology,
R.B.S.College, Bichpuri, Agra-283105, India
Tel: (+91) 562-2636675 (O) , (+91) 562-2636528(R)
Tel/FAX:(+91) 562-2636718
Mobile:(+91) 9412589080
e-mail : opsasd@gmail.com
          : opsagra2003@yahoo.co.in