Please register our following delegates for the above programme:-

S.No.	Name & Designation
1.
2.
3.
4.

The delegate fee Cheque / DD No .......................... dated ........................ for Rs. ..............
[ @ Rs.1600/- (CSI members & academic) / Rs. 1800/- (non-members) per participant]
drawn in favour of "Computer Society of India - Chennai Chapter" and payable at Chennai is enclosed.

Sponsoring authority

Name:

Designation:

Address:

Tel No:

Fax No:

Email :

Date :