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INDIAN TECHNOLOGY CONGRESS – 2018

“Technology First: Make India Innovate, Excel Globally and Prosper”


05 - 06 September 2018
NIMHANS Convention Centre, Bengaluru
Delegate Fees for the Indian Technology Congress
 Yes, I would like to attend the
Indian Technology  Rs. 5000/- per delegate for Industry / R&D Labs
Congress - 2018 during  Rs. 3,000/- per delegate for Academic & Professional Institutions
05 & 06 September 2018  Rs. 2,000/- per delegate for Research Scholars*
 I nominate the following  Rs. 1,000/- for Students** ; Rs. 1,000/- for Spouse of Participants
person/s to attend the (10% discount for more than FIVE delegates from the same organization)
conference
*Attested copy of Identity Card to be produced in case of Research Scholars
**Bonafide Student Certificate issued by the Head of the Department / Principal of the College must be
attached to the Registration Form

Participant Details

1. Name Designation Mobile:

2. Name Designation Mobile:

3. Name Designation Mobile:

4. Name Designation Mobile:

5. Name Designation Mobile:

Mailing Address

Phone Fax

Email

I / We would like to participate in the Indian Technology Congress – 2018 in the following manner
[ ] Delegate / Technical Paper Presentation [ ] AgriTech Workshop

[ ] Sponsor [ ] Drone Workshop

[ ] Exhibition Stall [ ] Advertisement

I/We enclose a Local Cheque / Demand Draft for Rs. ...................................... in favour of “Indian Technology Congress” payable at
Bangalore vide Cash / Local Cheque / D.D. No.................................... dated ........................................... drawn on Bank
...................................................................................................
On-line Payment

Account Name : Indian Technology Congress Account no. : 106100301000432 IFSC Code : VIJB0001061
Transfer Code / No. ________________________ Amount ________________________
Place ..................................
Date .................................. Signature
Please mail this form along with remittances to:
Organising Secretary - Indian Technology Congress
(Founded by Foundation for Educational Excellence)
#3, 4th Floor, First Main, BDA Layout, Kodihalli, HAL 2nd Stage, Bengaluru – 560 008.
Ph : 080 – 65592501 TeleFax : 48508380,
Email : participate@techcongress.net Web : www.techcongress.net

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