Training Programme on Library, Information Management and Web-based Outreach

Date: February 12-15, 2013

Name: *

Age: *

Organisation:: *

Address: *

Email: *

Website:

Contact telephone: *

Fax: *

Designation: *

Your educational background (Title / Degree; Institution; Year; Subject):: *

Your work experience (Period; Position; organization): *

Present Responsibilities: *

Why you wish to attend this course (2-3 sentences): *

What does the participant expect to learn?: *

Payment Options:

Cheque

Demand Draft

Credit Card

Please add Rs. 15 for outstation/ non-Delhi cheques:

DD/Cheque No. / Dated: *

Cheque/DD drawn in favour of Centre for Scienc and Environment

Would you like us to make arrangements for your accomodation (on payment basis: *

Yes

Name of the Nominating Authority and Designation: *

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