SNDS'12 REGISTRATION FORM

International Conference on Security in Computer Networks and Distributed Systems (SNDS'12)

11-12 October 2012, Trivandrum, India
REGISTRATION FORM
Salutation*
Full Name*
First Name Middle Name Last Name
Affiliation*
Registration Category*
EDAS Paper-ID*
Paper Title*

Address*

Phone Number*
- Area Code Phone Number
Mobile Number
- Area Code Phone Number
E-mail*
Nationality*
Dietary Preference

Vegetarian Non-Vegetarian
Do you like to serve as Session Chair?

Yes No
Payment Details
Mode of Payment*
Demand Draft
D.D Number
Date
Month Day Year
Amount
Bank, Branch
Net Transfer/Wire Transfer/Bank Transfer
Receipt/Transaction Number
Currency
Amount
Date
Month Day Year
Bank, Branch
DECLARATION
The details I have furnished in this form are true to the best of my knowledge. I agree to abide by conference ethics and rules of conduct set by the program chairs
Signature
It may be ensured that the Remitter's (Participant/Author) name, EDAS Paper-ID and the Registration Type are clearly mentioned by the Remitter in the Funds Transfer Application..
Please take printout of the registration form, affix your signature, scan it and mail to snds2012.iiitmk@gmail.com. Please do corrections (if any) manually.
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International Conference on Security in Computer Networks and Distributed Systems (SNDS'12)