Registration form for ACM Goa Networking Event
This event is meant for faculty members, researchers and working professionals from across Goa working in computing and technology-related fields for networking and fostering collaboration. 

Before filling up this form, you are requested to pay a nominal registration fee of Rs 100 via bank transfer (which can also be done via Gpay/netbanking etc) to the following account. The registration fee is intended to cover refreshments, logistics cost + Gst.

Bank Transfer Details:
Padre Conceicao College of Engineering
Bank : Punjab National Bank
Account no. 2531000101066694
Branch: Margao Goa
IFSC Code: PUNB0107810


Email *
Your Name *
Institute / Organization *
Institute Type *
Designation *
Contact Number (this is optional, and will not be shared with anyone)
Registration fee (INR 100) payment confirmation -  transaction ID *
Your areas of work/interest/expertise
Link to your webpage/profile/LinkedIn Profile (Optional)
Would you like to speak at the event on behalf of your institute/group/department to present a 5-6 min overview of the people and their work areas, projects and collaboration opportunities?  We request at-least one person from each institute to speak on behalf of their institute. *
Tell us a bit about what kind of collaboration or outcome you seek from attending this networking event
Any other information you'd like to share with the other attendees or your inputs for the event organizers. 
A copy of your responses will be emailed to .
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