62nd indian library association conference 2017 ila international
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rdThe 63 ANNUAL CONFERENCE OF
INDIAN LIBRARY ASSOCIATION-2017 International Conference
on Sustainable Development of Library and Information Science Profession
Title (Dr./Prof./Ms./Mrs./Mr.)
Full Name: ______________________________________
Designation:________________________________________
Department: _____________________________________________
Organization: ______________________________________
___________________________________________
Address: __________________________________________
____________________________________________
____________________________________________
City: _______________________________________
Postal code:_______________ Country_________________
Telephone: ________________________________________
Mobile: ___________________Fax____________________
E-mail: ___________________________________________
Signature: _______________________Date:_____________
For International Delegates
Passport No.:______________________________________
Issue Date: ________________________________________
Valid up to: _______________________________________
Issuing Country:___________________________________
Citizenship: _______________________________________
Travel Schedule
Particulars Date Time Mode of Travel
Arrival
Return
Payment Details
A demand Draft/NEFT/ ___________ ________
_________________for Rs/US $ _____________________
In favor of “ICSDLP-2017, BBAU, Lucknow”
____________
Signature of the Head of Department with Stamp(in case of student delegates)
Signature of Head Date: Office Stamp
Registration Form
(For payment by Foreign Delegates please refer to conference website)
Please Note:~ Registration fee is non-refundable.~ Registration will be confirmed only if the form is duly completed and payment received in full.
Contact Us
Dr. M. P. SinghOrganizing Secretary, ICSDLP-2017
Head, Department of Library & Information ScienceBabasaheb Bhimrao Ambedkar University, (A Central University)
Accredited ‘A’ Grade by NAACVidya Vihar, Rae Bareli Road, Lucknow226025, U.P., India
Phone: 9415951864, Email: [email protected], [email protected],BBAU Website: http://www.bbau.ac.in
Note: This form can be photocopied for the use of other Participants