REGISTRATION FORM

Name: Mr./Ms./Dr./Prof._______________________________________

Company/Affiliation:____________________________________

Address:______________________________________________

City:__________________________Country:________________

Postal Code:_______________

Phone:____________________________Fax:_______________

E-mail:_______________________________________

Category [please check the appropriate box] :

Speaker       Session Chair       Sponsor          Committee

Payments :

Total amount : US $/Rs.______________

Details of banker's cheque/draft:

      Number____________________Date_______________________

Drawn on_________________________________________

Payment is to be made by demand draft/bankers cheque in favor of "CIT 2000"

REGISTRATION FORM AND PAYMENT SHOULD BE SENT TO:

Prashanta Mishra
KIIT, Patia,
Bhubaneswar - 751 031
pkm@stpbh.soft.net
Tel:+91-674-441998/443271
Mobile :9861020944
Fax:+91-674-554464