First Name* | |
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Last Name* | |
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Designation* | |
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Department* | |
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Instituition* | |
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Email* | |
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Cell Phone #* | Your primary contact number |
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PMDC # | |
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Address | |
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City* | |
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Accommodation Required?* | |
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Accomodation Type | Must select one if accomodation required is 'Yes' |
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Payment Status* | |
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Sponsoring Institution/Company Name | Must enter sponsoring institution/company name. |
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Fee Deposit Proof |
Only required if you are not a speaker or not sponsored by any institution/company. |
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Human Verification* | 7 − 1 = ? |
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