WildCon 2020 - Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please Note :
1. Use this form to provide registration information.
2. The registration will be confirmed only when the payment is received.
3. Payment is to be made to our Bank Account as mentioned and payment details / screenshot is to be sent to the following e-mail ID : wildcon2020@gmail.com .
4. Please check our site https://wrtc.in for details on payment and registration

Email *

Confirm Email Address *

Please make sure you provide correct email address.

Salutation *

Dr.

Mr.

Ms.

Other:

Name *

As desired on participation certificate. Certificate once issued will not be changed.

Designation / Affiliation / Institute / Work Place *

Educational Qualification *

Phone Number *

Please include country code. We may use this to contact you to resolve any issue that might come up.

Registering As *

Please choose a valid option and make the payment directly to our bank, along with an email with payment details / screenshot to wildcon2020@gmail.com for registration confirmation.

Life Member, AIZ&WV - 500 INR

Non Member - 500 INR

Student - 200 INR

Foreign Delegates - 10 USD

Foreign Student - 10 USD

Country *

Your registration will be confirmed only when the registration fees has been paid. *

I understand and I will check the website wrtc.in for payment details and once the payment is done I shall send the details / screenshot to email wildcon2020@gmail.com

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Vsurg. Report Abuse

Forms