Name of the participant: 

(Please use block letters. The certificate will be made in this name)

Category:

Tick appropriate

Industry Member

(Non-VSI)

Member of:

Membership No:

VSI/ IEEE member

VSI/ IEEE Membership No:

Academic/governmental organization from India (Non-VSI)

Member of:

Membership No:

Academic/governmental organization from India (VSI/ IEEE member)

VSI/ IEEE Membership No:

If you are a student, mention Semester/Year:

Contact Address:

(Provide permanent mailing address)

Designation: Student   Faculty   Industry   Other  

College/ Company:

Permanent address:

E-mail:

(Compulsory)

Background in VLSI: (Courses/Reading/Projects)

Details of DD enclosed

DD Number

Drawn on Bank

Dated

Your background and expectations from the workshop:

Signature

After completing the registration form, mail it with the DD to the following address:

Mr. Gopal Naidu

Treasurer, VLSI Society of India

Finance Department

Texas Instruments (India) Pvt Ltd

Bagmane Tech Park

C.V. Raman Nagar, Bangalore 560093

Please also e-mail the details of payment to vsisecy@vlsi-india.org

·          Please make the DD to “VLSI Society of India” payable at Bangalore.

·          On the back of the DD, please write “3-day Course on Design for Testability – Theory and Practice, Bangalore” to avoid confusion.

·          Partial registration is not permitted. Processing fee of Rs.1000/= will be charged against cancellation.

·          Queries may please be sent to: vsisecy@vlsi-india.org

·          Seats are limited to 50. Spot Registration against cancellations, and strictly by cash payment.

·          Venue: Hotel Fortune Katriya, Hyderabad

Note:

·          Course fee includes registration material, vegetarian lunch and refreshments on all the days.

·          Transport and stay arrangements are the responsibility of the participants.

·          Registration can be transferred to a colleague with intimation 15 days prior to the event.

·          Registration on Day-1 at 8.30 AM, Course on all days from 9.00 AM to 6.00 PM.

·          DD Acknowledgement through mail confirms registration.