CICT-2017 ACCOMMODATION FORM
CONFERENCE ON INFORMATION AND COMMUNICATION TECHNOLOGY - 2017
NOVEMBER 3-5, 2017 // ABV-IIITM Gwalior
(Jointly organized by ABV-IIITM Gwalior, IIIT Allahabad, PDPM IIITDM Jabalpur, and IIITDM Kancheepuram)
1. NAME OF DELEGATE *
Your answer
2. DESIGNATION *
Your answer
3. AFFILIATION/ ORGANIZATION *
Your answer
4. CONTACT NUMBER (MOBILE) *
Your answer
5. E-MAIL ID *
Your answer
6. TYPE OF ACCOMMODATION
For Accommodation details, go to http://cict2017.org/travel.php
7. ACCOMMODATION IS REQUIRED FROM *
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DD
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YYYY
Time
:
8. ACCOMMODATION IS REQUIRED UPTO *
MM
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DD
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YYYY
Time
:
9. AMOUNT PAID for ACCOMMODATION *
Your answer
10. MODE OF PAYMENT:
For Payment details, go to http://cict2017.org/registration.php

If accommodation payment is already done with paper registration, please ignore the 11(A) and 11(B) points.

11(A). SELECT ONE OF THE PAYMENT MODE
11(B). PLEASE, PROVIDE TRANSACTION ID/ REFERENCE NO./ DD NO.
Your answer
IMPORTANT NOTE:-
Kindly, e-mail the proof of payment (scan copy) to cict2017.gwl@gmail.com.
(Please ignore if you have already sent the proof of payment)
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