REGISTRATION FORM for IWCIA'15 Tutorial on 24-Nov,2015 First name: Middle name: Surname(s): Gender: Dietary Preference: Vegetarian / Non-Vegetarian Current position: Institution: Department: Address: Postal code: Phone Number: Mobile Number: E-mail: ------------------------------------------------------------ Already registered to the main workshop (24 to 27 Nov)? (Yes/No) If not, please make a payment of Rs. 2000 within 15-Oct-2015, to Indian Statistical Institute, as per instructions given in http://www.isical.ac.in/~iwcia2015/registration.html Mode of Payment: Demand Draft / Net Banking Payment Date: Any other info: