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UNIVERSITY DETAILS

Name of University *
Postal Address *
Postal Code *
City *
Faculty email Address *

TEAM DETAILS

Name of Speaker 1
Email
Phone *

TEAM DETAILS

Name of researcher *
Email *
Phone *

PERSONAL DETAILS

Name of registering officer *
Position Held *
Personal Email Address *
Phone Number *

TEAM DETAILS

Name of Speaker 2 *
Email *
Phone *

BANK DETAILS

Amount Paid *
Bank Name *
Bank Slip No. *

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