| Current Path : /var/www/html/mmishra/indem/isvs/ |
| Current File : /var/www/html/mmishra/indem/isvs/registration1.inc |
<div class="post" align='post'><br>
<p><h2><font size='3'> Registration</font></h2></p><br><br>
<dir><!--<a href='regform1.pdf'>Registration Form</a><br>-->
<p align=justify>Delegates attending the Seminar will be able to complete the registration and submit it online to the Seminar Secretariat. A copy of the registration can be printed for their record. Seminar Secretariat will send an email confirming acceptance of the registration. This will be subject to deposit of the Demand Draft for Rs. 300.00 [Rupees three hundred only] in favor of Indian Institute of Information Technology Allahabad payable at Allahabad on registration at RGIIT.</p>
<p align=justify>Student delegates are required to submit a letter from the Institute/College on registration at RGIIT.</p>
<br>
<dir>
<?php
include "mail1.php";
?>
<table>
<tr><td><p>Name:</p></td>
<td><input type="text" name="name" size="50"></td>
</tr><tr><td><p>Gender:</p></td>
<td><select name="gender">
<option value="Male">Male</option>
<option value="Female">Female</option>
</select></td>
</tr><tr>
</tr><tr><td><p>Category:</p></td>
<td><select name="category">
<option value="GEN">General</option>
<option value="OBC">O B C</option>
<option value="SC">S C</option>
<option value="ST">S T</option>
</select></td>
</tr><tr><td><p>Background:</p></td>
<td><select name="background">
<option value="Urban">Urban</option>
<option value="Rural">Rural</option>
</select></td>
</tr><tr>
</tr><tr>
<td><p>Designation:</p></td>
<td><input type="text" name="designation" size="50"></td>
</tr><tr>
<td><p>Organization:</p></td>
<td><input type="text" name="organization" size="50"></td>
</tr><tr>
<td><p>Address:</p></td>
<td><textarea name="address" rows="4" cols="38"></textarea></td>
</tr><tr>
<td><p>Phone:</p></td>
<td><input type="text" name="phone" size="50"></td>
</tr><tr>
<td><p>Email:</p></td>
<td><input type="text" name="email" size="50"></td>
</tr><tr>
<td><b><p>Presenting Paper</p> </b></td>
<td><input type="checkbox" name="paper" value="Y">Yes</td>
</tr>
</tr><tr>
<td></td>
<td><input type="submit" name='submit' value="SUBMIT"> <input type="reset" value="RESET"></td>
</tr>
</table><br>
</dir>
<a href='form.pdf'><b>Download Registration Form</b></a>
<input type='hidden' name='pg' value='<?php echo $pg ?>'>
</div>
</dir>
</div>