* User Name: (Email_ID)

* Confirm (Email_ID)

* Confirm Password:

Salutation:

* First Name:

Middle Name:

* Last Name:

* Organization:

* Desiganation:

Email Id-2(Author):

* Contact no (Author):

* Mobile No(Author):

Fax No (Author):

* Address line-1( Author):

Address line-2( Author):

* City (Author):

* ZipCode (author):

* State (Author):

* Country (author):

Contact no (Organization):

Fax no (Organization) :

Addressline-1( organization):

Address line-2( organization):

City (Organization):

Zipcode (Organization):

State (Organization):

Country (Organization):

Note : Demand draft should be drawn in favour of "Institute of Technology, Nirma University", payable at Ahmedabad. The registration form should be supported by bonafide certificate for M.Tech. & Ph.D. students (non-sponsored).