Registration

insig_cii

REGISTRATION FORM
(Only for Indian Citizen)

Please read the following carefully for the registration:

Please fill the separate form each individual joining the event.
Please provide an active email ID, as confirmation copy and further information will be sent to this email ID.
A copy of Govt. issued photo ID card (Aadhar Card/ Driving License/ Passport / Voter ID Card) will be required to upload during the registration. The participant should carry the same document for the for the entry to RRCAT lab area during the event.
UPI payment of Rs. 1,180/- (includes 18% GST) as registration fee needs to be paid and UTR No. to be included in the field.

E-mail ID(*)

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Name(*)

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Mobile(*)

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Designation(*)

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Company Name(*)

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CII Membership No.

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Govt. issued photo ID card Details

Select Govt. ID(*)

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Govt ID No.(*)

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Upload Govt. Issued ID (pdf <200KB)(*)

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	Registration fee: Rs. 1180/- including 18% GST
	ACCOUNT NAME	AIC PI-HUB
	ACCOUNT NO.	50200091302220
	IFSC CODE	HDFC0002140
	BANK NAME	HDFC BANK
	BRANCH	Rau, Indore
	ADDRESS	Sai Vihar Colony,Rau, INDORE-453331

Payment Details (UTR No.)(*)

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Payment Date(*)

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Declaration(*)

By submitting this form, I hereby declare that the information given above and in the enclosed documents is true to the best of my knowledge and belief and nothing has been concealed therein. I understand that if the information given by me is proved false/not true, I will have to face the punishment as per Atomic Energy Regulation Act 1962 and other relevant Indian law.

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Captcha(*)

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