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  • Registration Form

    Transféré par

    dkacharya007
    87 vues2 pages
    This document is a registration form for the 53rd Annual Conference of the Association of Microbiologists of India to be held from November 22-25, 2012 in Bhubaneswar, India. The form requests personal details of delegates such as name, organization, address, city, postal code, country, telephone, and email. Delegates can indicate if they are interested in attending the conference, doing an oral or poster presentation. If presenting, the title and topic area are requested. Topic areas include microbial biodiversity and climate change, environmental microbiology, agriculture/veterinary microbiology, and others related to microbes. Payment details such as demand draft number and date are also solicited.

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    This document is a registration form for the 53rd Annual Conference of the Association of Microbiologists of India to be held from November 22-25, 2012 in Bhubaneswar, India. The form requests personal details of delegates such as name, organization, address, city, postal code, country, telephone, and email. Delegates can indicate if they are interested in attending the conference, doing an oral or poster presentation. If presenting, the title and topic area are requested. Topic areas include microbial biodiversity and climate change, environmental microbiology, agriculture/veterinary microbiology, and others related to microbes. Payment details such as demand draft number and date are also solicited.

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
    Téléchargez comme DOC, PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    87 vues2 pages

    Registration Form

    Transféré par

    dkacharya007
    This document is a registration form for the 53rd Annual Conference of the Association of Microbiologists of India to be held from November 22-25, 2012 in Bhubaneswar, India. The form requests personal details of delegates such as name, organization, address, city, postal code, country, telephone, and email. Delegates can indicate if they are interested in attending the conference, doing an oral or poster presentation. If presenting, the title and topic area are requested. Topic areas include microbial biodiversity and climate change, environmental microbiology, agriculture/veterinary microbiology, and others related to microbes. Payment details such as demand draft number and date are also solicited.

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
    Téléchargez comme DOC, PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 2

    REGISTRATION FORM

    53rd Annual Conference of


    Association of Microbiologists of India (AMI)
    International Conference on Microbial World: Recent Innovations and
    Future Trends
    November-22-25, 2012
    Personal Particulars of Delegates
    (Please type clearly and use separate registration form for each delegate)
    Please tick
    Prof.
    Dr.
    Mr.
    Mrs.
    Ms.
    First Name: __________________________________________________________
    Last Name: __________________________________________________________
    Organization: __________________________________________________________
    Address : __________________________________________________________
    __________________________________________________________
    City:________________ Postal Code:_______________ Country:______________
    Tel:______________________________ Email:_____________________________
    I am interested in
    Attending the conference for
    Presentation

    Poster presentation

    Oral

    Title of
    Paper/Poster:__________________________________________________________________
    ____________________________________________________________________________________
    Area of Paper/Poster Topic (Please tick accordingly):
    Microbial Biodiversity & climate
    change
    Environmental Microbiology
    Agriculture
    /Veterinary
    Microbiology
    Medical Microbiology/Immunology
    Virology
    MolecularMicrobiology/Nanobiotech
    nology

    Food/ Industrial Microbiology


    Biofuel / Bioenergy/Biopolymer
    Microbial process Bioengineering
    Translational Microbiology
    Biodeterioration & Biodegradation
    Genomics,
    proteomics
    and
    Metagenomics

    Payment
    DD No.* & Date : _________________________________________*The Demand Draft (DD)
    should be drawn in favour of 53rd Annual AMI Conference, payable at
    Bhubaneswar

    Signature
    Date:

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