Registration form

COMPOSITE MATERIALS: OVERVIEW,

CHARACTERIZATION AND
APPLICATIONS (CMOCA-2018)
[July 16-20, 2018]

Name: Arnav Gupta

Designation: Student

Department: Civil Engineering

Institute: Birla Institute of Technology and Sciences Pilani

Address: B-127 Mehdauri Colony , Telierganj , Allahabad -211004

Email: ar9avg@gmail.com

Mobile Nos: +91-9649762878

Qualification: 2nd Year of College

Area of specialization: Structural Engineering

Prior exposure to composites: -

Payment Details:

Amount in Rs: 1500

Transaction ID (in case of online transfer)..........

Date of Transaction :

(Please enclose transaction slip)

Sponsored by : -

Name :

Designation :

Organization : Signature of applicant

Recommendation (Signature of Head of the Institution/ Head of the Department with seal)