Registration Form First NameMiddle NameLast NameDesignation *DesignationIndustrial PersonnelAcademia/Research ScholarsStudents (Graduate/Master)Foreign DelegatesOtherOrganization *Street Address *City *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People’s Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwePhone *Email Address *Accommodation *AccommodationNot RequiredA.C. Single ₹1500/dayA.C. Double ₹2000/dayNon-A.C. Single (subject to availability) ₹1200/dayNon-A.C. Double ₹1800/dayHostel/Guest House (sharing) ₹1000/dayNo. of days required for accommodation *No. of days required for accommodation1 Day2 Days3 Days4 Days5 DaysN/ARegistration Fee *Registration FeeIndustrial Personnel ₹3000 (Offline mode)Industrial Personnel ₹1500 (Online mode)Academia/Research Scholars ₹2000 (Offline mode)Academia/Research Scholars ₹1000 (Online mode)Graduate/Master Students ₹1000 (Offline mode)Graduate/Master Students ₹500 (Online mode)Foreign Delegates $50/₹4000 (Offline mode)Foreign Delegates $50/₹4000 (Online mode)Other (online/ offline) (any amount)Sponsorship / Advertisement (online/ offline) (any amount)Total AmountTotal AmountUpload Screenshot of your Payment *Choose FileNo file chosenDelete uploaded file.jpg .jpeg .png max size 200kbDate *Submit Payment Methods Payment by Bank Transfer State of Bank India Beneficiary: Haldia Brajalalchak Welfare Organization Account No: 38316201018 Account Type: Current IFSC: SBIN0009390 MICR Code: 721002004 Bank Name: State of Bank India Bank Address: PO – Debhog, City Centre, Haldia, PIN – 721657, Purba Medinipur, West Bengal CANARA BANK Beneficiary: HSE Conference Account No: 110077503182 Account Type: Saving IFSC: CNRB0019558 Bank Name: Canara Bank Bank Address: HIT Campus Branch, Haldia-721657, Purba Medinipur, W.B. Payment via Phone pe Google Pay : + 91-8609460285 Phone pe / Google Pay