Registration Form
National Workshop On
Optimization of Mathematical Models and Their Applications
01 – 06 July 2013
SPONSORED BY
Department of Science and Technology
Government of India, New Delhi
ORGANISED BY
Department of Industrial Engineering and Management
M.S. RAMAIAH INSTITUTE OF TECHNOLOGY
(Autonomous Institute, affiliated to VTU, Belgaum)
Name of the participant
Age
Sex
Male / Female
Designation
Qualification
Area of Interest/
Specialization
Experience
Name and Address of the
affiliated Institution
Address for correspondence
E-mail Id
Telephone numbers (with STD codes)
Office
Residence
Mobile
Registration Fee (DD to be drawn in favour of ‘The Principal, MSRIT’ payable at Bangalore)
DD no & Date
Bank & Branch
Amount (Rs)
Signature of the Applicant
Signature & Seal of the Principal/ Sponsoring Authority
For Information, Communication & Registration:
Dr. N.V.R.Naidu
PH : 080-23600822 EXTN: 323 (O), 09886844934(M); Email: nvrnaidu@gmail.com
Dr. Mohan Babu G.N. PH: 080-23600822 EXTN: 323 (O), 09632555300 (M); Email: gnm@msrit.edu
Dr. S. Bharath
PH: 080-23600822 EXTN: 323 (O), 07760661187 (M); Email: sbharath@msrit.edu
Website: www.msrit.edu