Submission Form

Registration/Advertisement/Sponsorship Order Form

To
Dr. HasanShaikh,s
Chairman, Preparatory Committee, IC 2017
Email: hasanshaikh.ic2017@gmail.com Mobile: +91 9159595363

Dear Sir,

I / We would like to register for the International Congress 2017/Young Professional International Conference 2017/ Weld PCT 2017 to be held at Chennai from 7 to 9 December 2017 for the following delegates

I / We would like to

I / We would like to reserve advertisement space in the Souvenir of the IIW International Congress 2017 and/or sponsor as detailed below:

We have transferred the amount of Rs. as per the following details.
DD No.: dated of Bank, payable at Chennai.
Transaction Ref. No. (in case of online transfer) of Bank dated .

Submitted by :

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Organisation

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