ICDK 2011 Registration Form

International Conference on Digital Libraries & Knowledge Organization

February 14-16, 2011

Delegate Information Participation Details

(Name and Address in Capital Letters)

DELEGATE NAME
(Forename) (Middle Name) (Surname) Charges on or before Charges after
CONFERENCE & TUTORIALS January 1, 2011 January 1, 2011
ORGANIZATION/INSTITUTION
Indian & SAARC Country Delegates Rs. 4,000/-  Rs. 5,000/- 
POSTAL ADDRESS
Other Foreign Country Delegates US$ 150  US$ 200 

CITY STATE/PROVINCE
Ph.D. Students Rs. 3,000/-  Rs. 3,500/- 
ZIP CODE Country

PHONE FAX
EMAIL Demand draft/Cheque no. Dated for Rs/US$

MOBILE (drawn in favour of Management Development Institute, payable at Gurgaon/Delhi) is

sent herewith.
PROFESSIONAL DISCIPLINE

DELEGATE STATUS
Signature of Sponsoring Authority Signature of the participant
 SAARC Delegate
 Foreign Delegate
 Indian Delegate Date:____________________________ Date:____________________________

 Ph.D. Student
Details of International Delegates Place:___________________________ Place:___________________________

PASSPORT NUMBER
NB: In case of outstation or International Cheques, please include appropriate bank
transaction charges along with your Demand Draft/Cheques
NATIONALITY (as in passport)

PLACE OF ISSUE

DATE OF ISSUE/LATEST RENEWAL (dd/mm/yy)

DATE OF EXPIRY