Registration Form

REGISTRATION FORM

U.G.C. sponsored 2-Days National Conference on

“Re-Visiting the Fictional World of R.K. Narayan”

(February 27 & 28, 2011)

Name:   Mr./Ms./Prof._______________________________________________________

Designation:  ___________________________________________________________________

Institution:  ___________________________________________________________________

Address:    __________________________________________________________________

                    __________________________________________________________________

                    Distt.: ___________________  State: ___________________ PIN: ___________

Phone No.:   _________________  Mobile: ____________________  Fax: ________________

Email:    __________________________________________________________________

Participation as:    Paper Presenter/Delegate/Student Delegate:  _________________________

Date:  __________________                                     Signature:            ______________________

CERTIFICATE

(For Paper-Presenters Only)

I __________________________ certify that the paper titled

_____________________________________________________________________________________________________________________________________________________________________________________________________ is my original work and has not been submitted for publication/presentation anywhere else.

Date:  ___________________                                   Signature:   _______________________