10th ANeT International Conference 2015
CONFERENCE REGISTRATION FORM
(Please complete the form and return to anet2015@kln.ac.lk as soon as possible. Registration will be completed only
after the payment of the registration fees.)
A. Personal Details
Title
Prof.
Dr.
Mr.
Ms.
First Name
Surname
Date of Birth (dd/mm/yyyy)
Category of Registration
Gender
Author
Attendee
Additional Reg.
E-mail
Telephone :
Office
Mobile
University / Institution
Department / Division
Address
Country
B. Conference Details
T-shirt
Meal Preferences
(Give details where necessary)
Ant Excursion :
I participate in the Excursion
Do you need a detailed invoice for the
payment of registration fee?
XL
L
Vegetari
an
NonVegetarian
YES
NO
YES
NO
Registration fee should be paid on the first day of conference.
* Before sending the completed file please check the details.
Date :
Signature:
Page 1 of 1
M
S
Any other
(Please
specify)