CERA Registration Form
  1. First Name(*)
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  2. Middle Name
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  3. Last Name(*)
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  4. Designation(*)
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  5. Organization(*)
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  6. Mailing Address(*)
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  7. City(*)
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  8. Country(*)
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  9. Mobile No.(*)
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  10. Land Line No.
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  11. Email ID.(*)
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  13. Passport No.(*)
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  14. Date of Issue

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  15. Date of Expiry

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  16. Place of Issue
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  17. Category(*)
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  18. IEEE Membership No
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  19. Registration Type(*)


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  20. Select Paper(*)
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  21. I need accommodation
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  22. Please note that limited number of rooms will be available in IIT Roorkee guest houses on payment basis.
  23. Number of person accompanied during the conference (if any)
    Maximum 2 person can be accomodated
  24. Amount(*)
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  25. Mode of Payment
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  26. Please enter NEFT transaction ID or demand draft number(*)
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  27. Please Enter the Text(*)
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  28. Mode of Payment:
    Through NEFT:
    Name of Bank: State Bank of India
    Branch Office: Indian Institute of Technology Roorkee 247667
    Account name: Conference, Seminar & Symposium, IIT Roorkee
    Account No.: 33136732957
    Branch Code: 1069
    IFSC Code: SBIN0001069
    MICR Code: 247002094
    Through Draft: The Draft should be made in favor of "Dean SRIC, INDIAN INSTITUTE OF TECHNOLOGY, ROORKEE"
    Please send your Draft to:
    Dr. Barjeev Tyagi
    Organizing Secretary, CERA17
    Department of Electrical Engineering
    Indian Institute of Technology Roorkee
    Roorkee, Uttarakhand
    Pin 247667