REGISTRATION FORM ( Please fill in block capitals )

6TH ALL INDIA INTER ENGINEERING COLLEGE ACADEMIC MEET 2015

Presentation of Papers on 26th April 2015

at MCKV INSTITUTE OF ENGINEERING

243 G. T. Road (N), Liluah Howrah 711204 Phone: (033) 2654 9315/17, Fax: (033) 2654 9318

Website: http://www.mckvie.edu.in Organised by:

FORUM OF SCIENTISTS, ENGINEERS & TECHNOLOGISTS (FOSET) 15N, Nelli Sengupta Sarani (Lindsay Street),

New CMC Building (5th Floor), Kolkata 700 087 Phone: (033) 22529675, Fax: (033) 22520521

E-mail: foset@rediffmail.com In association with:

MCKV INSTITUTE OF ENGINEERING

Paper Code No.:_________________________________

Name: Mr. / Ms . (First Name) (Middle Name) (Surname)

Name of Institute .:

Address .:

..

Phone (including STD Code) .

Fax (including STD Code) .

Mobile Phone Number (for contacting) ..

E-mail: .

Category ( ) Paper Presenter / ( ) Delegate/ ( ) Model Exibition Registration Fee (@Rs.150.00) [Exempted for Principal / Presenting Author] : by Cash / Cheque / DD No.:

(Signature of communicating author) Place: Date :

Countersigned by Head of the Department / Institute with seal