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3
rd
International Conference on Human Behaviour and Development
Issues (ICHBDI 2016)
CONFERENCE REGISTRATION FORM
Lucknow-India
Please complete and return by e-mail or regular mail.
Date : 20-21
st
October, 2016
Venue : Amity University Uttar Pradesh, Lucknow Campus
Near Malhaur Railway Station, Gomti Nagar Extension
Lucknow - 226028
Participants Information
Family Name: _____________________________________________________________________________
Title:_______ Prof. Dr. other:________________________________________ Mr. Ms. Mrs.
First Name: _______________________________________________________________________________
Organisation: _____________________________________________________________________________
Address: _________________________________________________________________________________
Postal/Zip Code: ________________________ City: ______________________________________________
Country: _________________________________________________________________________________
Telephone/Mobile: _________________________________________________________________________
Fax: _____________________________ E-mail: _________________________________________________
Registration Fees
Last day for registration will be 20th August 2016
Registration fee includes conference bag, lunch, and tea/snacks. Conference bag is not
guaranteed for spot registrations.
Fee does not cover the cost towards accommodation, other meals, pick-ups and airport
transfer.
Register for the Conference Dinner by paying INR 500.
*Please include a copy of your valid student card/other formal identification.
Mode of Payment
Registration can be made by demand draft of any Nationalized Bank in favour of 'Amity University
Uttar Pradesh' payable at Lucknow.
The demand draft should be attached to the fully filled registration form and sent by post to the
address mentioned in the registration form.
OR
Delegates can directly deposit fee through Electronic Transfer to the under mentioned account
Bank Name: Axis Bank Limited
Address: Lucknow Branch, 25 B, Ashok Marg, Sikander Bagh Chauraha, Lucknow – 226001
Account Number: 053010100284066
Type of Account: Saving Account
IFS Code: UTIB0000053
MICR Code: 226211002
NOTE: Do not forget to mention the electronic transfer details on the registration form.
E-mail the completed form to registeri[email protected]
Deadlines
Students
Professionals
NRI/Foreign Nationals
Before August 20th, 2016
1200/-
2100/-
US $ 85
Before September 10th, 2016
1500/-
2700/-
US $ 95
Before September 30th, 2016
2000/-
3300/-
US $ 110
On the Spot
2500/-
3900/-
US $ 130