Conference Delegate Registration Form

Please tick ()

[ ] I will attend this conference.

[ ] We nominate the following from our organisation to attend this conference.

NameDesignation E-mail Mobile

1. ______

2. ______

3. ______

4. ______

5. ______

Delegate Fee

(Per Participant/including Service tax)

Category / Rs. (INR)
CII Member / 4000
Non Member / 5000
Academic Institution / 3000
Overseas Participant / 6000

Note:  Delegate fee is non-refundable.  Change in nomination is accepted

 For every Four registrations, one will be complementary * Prior registration is essential

* We would accept the nominations on first-come-first served basis.

Our Cheque/DD No.______for Rs. ______dated ______Bank: ______drawn in favour of Tamil Nadu Technology Development and Promotion Center payable at Chennai is enclosed.

Membership No. ______(only CII Member)

Nominated by: Name: ______Desig.: ______

Company:______

Address:______

Phone: ______Fax: ______

Email:______Mobile: ______

You are requested to send your reply by email, post or fax to:

K Samuel Johnson

Tamil Nadu Technology Development and PromotionCenter

Confederation of Indian Industry

98/1, Velachery Main Road, Chennai 600 032, IndiaTel: +91-44- 42444555/ 530 (D)
Mob. 9840948053 Fax: +91-44- 42444510Email:

Bank details for wire/NEFT transfer

1 / Name of the Centre / TAMILNADU TECHNOLOGY DEVELOPMENT AND PROMOTION CENTRE
2 / Address / No.98/1, Velacherry Main Road,
Guindy, Chennai 600032, India
3 / Phone no. / 044-42444555/530
4 / E.Mail / ;
5 / Legal Status / Society, Registered under T.N. Societies Act 1975, Reg.no.190/2005
6 / Contact person / K.SAMUEL JOHNSON
7 / Mobile no. / 9840948053
8 / Permanent Account no. / AABAT1588L
9 / GST No. & SAC Code / GST:33AABAT1588L1Z7
SAC: 998596
10 / Name of the Bank / STATE BANK OF INDIA
11 / Address / No.5, 1st Cross Street, Kasthuribai Nagar, Adyar, Chennai 600020
12 / Account no. / 10792456240
13 / Type of Account / Current Account
14 / Name of the branch / SME ADYAR
15 / IFS Code / SBIN0013361