ICPE 2019 Registration Confirmation by Grant Awardee

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Grant awardees should submit this form to confirm that they have registered for ICPE 2019.

Full Name (as submitted in Travel Grant Application) *

ICPE 2019 Travel Grant ID *

Mention the Grant ID that has been sent to you in your notification.

ICPE 2019 Registration Number *

All grant awardees must first register for ICPE 2019 (conference or conference+tutorial/workshops), and then enter their registration number here

I have registered for *

Conference only

Conference + Tutorial/Workshops

Accommodation preference. We can provide guest house at IIT Bombay, at Rs 1000/day with double occupancy, or Rs 870/day with extra person (3-person sharing) *

I do not want accommodation at IITB Campus Guest House

I would like Guest house with double occupancy, I do not want triple occupancy

I would like Guest house with double occupancy, I am also ok with triple occupancy

Bank information for reimbursement

Please enter all information accurately to avoid delays later in reimbursement.

Bank Name and Branch *

IFSC Code *

Name on Account *

Account Type *

Savings

Current

Other:

Account Number *

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