ICIER-IIMB International Conference on

Entrepreneurship Education and Training

29-31 January 2015

Registration Form

Name: ______Gender: ______

Designation: ______Organization: ______

Address: ______

______

Phone______Mob.______Email______

Attending the conference/ presenting paper______

Passport Details (For foreign nationals only)

Passport No: ______Date of Issue: ______Place of Issue: ______Date of Expiry______

PAYMENT DETAILS:

Total Payment Due: / Currency / Amount
Conference Registration Fee / EURO/USD/ INR
Accommodation at IIMB Campus (Only for registered participants). Amount (single/double room)* No of days / EURO/ USD/INR
Total / EURO/USD/INR

ONLINE MONEY TRANSFER*

For payment through Net-banking, kindly mention “ICIER-IIMB CONFERENCE” for tracking the transfer details.

I have remitted an Amount of EURO/USD/INR/ ______dated ______through (Bank Name)______and Transaction ID ______towards the Registration Fee for the ‘ICIER-IIMB Conference’.

Participants are requested to send the registration form along with transfer details to .

DEMAND DRAFT (DD) DETAILS

DD No.______dated ______for EURO/USD/INR ______drawn on (Bank name)______in favour of Indian Institute of Management Bangalore.

Participants are requested to send the registration form along with DD/ payment details to: Dr. Mathew J. Manimala, Professor of Organization Behaviour & Chairperson-OBHRM Area, Indian Institute of Management Bangalore, Bannerghatta Road, Bangalore-560 076, India.

Signature______

*See Annexure below for details

ANNEXURE

ONLINE BANK TRANSFER INFORMATION

Remittance Details for routing funds through HDFC Bank :(inward remittances)
Details / USD / GBP / Euro / SGD
Please transfer funds to / J P Morgan Chase Manhattan Bank / J P Morgan Chase Manhattan Bank / J P Morgan Chase Manhattan Bank / J P Morgan Chase Manhattan Bank
New York / London, U K / Frankfurt, Germany / Singapore
Swift Code: CHASUS33 / Swift Code: CHASGB2L / Swift Code: CHASDEFX / Swift Code: CHASSGSG
A/c No. / 0011406717 / 11135191 / 6231602308 / 111874122
Swift Code: HDFCINBB IFSC Code: HDFC0000133
For further credit to HDFC Bank Ltd
HDFC Bank Ltd., J. P. Nagar Branch, Bangalore, SB A/c No. 01331450000019, favouring Indian Institute of Management Bangalore

CONFERENCE REGISTRATION FEE

Conference Fees (Service Tax Included) / Euro/
Dollar/ INR / Early Bird Registration Fee (Before 30th October 2014)
Academic participants from Developing Countries / € 100
$ 130
INR 8,000 / € 70
$ 90
INR 5,000
Non-Academic participants from Developing Countries / € 130
$ 170
INR 10,000 / € 100
$ 130
INR 8,000
Full time students from Developing Countries* / € 35
$ 45
INR 2,500 / € 30
$ 40
INR 2,000
Academic participants from Developed Countries / € 200
$ 260 / € 150
$ 200
Non-academic participants from Developed Countries / € 250
$ 340 / € 225
$ 300
Full time students from Developed Countries* / € 50
$ 65 / € 45
$ 60
*Full time students should attach copy of valid testimonials/ Student Identity Card along with Registration Form.

ACCOMMODATION AT MANAGEMENT DEVELOPMENT CENTRE (MDC) ON IIMB CAMPUS

Room (prices per day) € $ INR

Double-seated room per person:30 45 2,000

Single seated room: 45 60 3,000