Hazop Registrations 2014
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Full Name *
Designation *
Organization *
Complete Mailing Address
Country *
Email ID *
Contact (Mobile) No:
Please explain the reasons for your interest to attend the workshop and Relevant Background you have (If Any)
(optional)
Preferred Mode of Payment
Indicate your preferred mode of payment
Registration Details
Registration Fees (includes Attendance to all sessions, Handouts Study Materials, Lunches and Tea Breaks for two days ) : 5000/- per participant

Payment can be made either through Demand Draft or Online Bank Transfer (Details Below):

1. For Demand Draft:
Name of Account: Conference Account IIT Gandhinagar
Name of Bank: State Bank of India, Branch: IIT Gandhinagar
Account No: 33674204979, IFS/ RTGS Code: SBIN0011770

2. For online bank transfer:

Name of Bank: State Bank of India, Branch: IIT Gandhinagar
Account No:33674204979, IFS/ RTGS Code: SBIN0011770                                              
MCIR Code:380002106, Swift Code:SBININBB417                                                    

During online Bank Transfer, please write the name and organization (First Name Second Name, Organization) of the attendee in the REMARKS).


Mail the Draft/Proof of Online Bank Transfer along with Registration form to:

Safety Centre
Attn: Prof. Chinmay Ghoroi
Indian Institute of Technology Gandhinagar (Office : S3/224)
VGEC Campus, Chandkheda, Ahmedabad, Gujarat - 382424
Tel: +91-79-32459897 • Fax : 91-79-23972586
Email: safety@iitgn.ac.in
Web: http://safety.iitgn.ac.in
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