REGISTRATION FORM

NATIONAL SEMINAR ON CARBON CAPTURE, SEQUESTRATION AND TRADING (CCST-2008)

Date : September 12-13, 2008 Venue : The Tollygunge Club, Kolkata Jointly organized by: Indian Association for Productivity, Quality and Reliability & Millennium Institute of Energy and Environment Management

1. Name:

2. Organisation:

3. Address:

4. Designation:

_________________

Department:

___________________

5. Male/Female:

6. Residential Address:

7. Telephone No.

(O): ___________

(R):____________

(M):____________

8. Fax:

_________________

E-mail:

___________________

9. Food Habit:

Veg. / Non-Veg.:

_______________________

10. Whether accommodation required : Yes / No :

___________________

11. No. of accompanying persons: Male:

________

Female:

________

12. Whether presenting a paper : Yes / No:

___________________

If yes, title of Paper:

______________________________________

13.	Registration Fee of Rs. _______________ being paid in Cash/ Cheque/ Demand Draft No. _________________ dated _____________________ drawn on __________________________________ Bank.

Date : ________________

Signature

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The filled-in registration form alongwith fee must reach in the following address : Shri S. K. Banerjee, Convener, CCST-2008 C/O. Cybernet, 203, Sarat Bose Road, Kolkata-700 029