The Registration form as well as the D. D. and the summary of the paper, should be mailed to Shri. R. L. Sawant, Coordinator, 42nd Annual Conference of Institute of Historical Studies, Dept. of History, S. S. & L. S. Patkar and V. P. Varde College, Goregaon (West), Mumbai - 400 062, Maharashtra State on or before 31st October 2005
   
Name ______________________________________
Address with designation: ______________________________________

(a) Phone Official :

______________________________________
(b) Phone Residential: ______________________________________

Membership :

 Patron/Life/Annual
Title of the paper : ______________________________________

Mode of arrival :

______________________________________
   
Arrival Details  
Arrival Mumbai on
___________ (Date)
by
 ___________ (Train No)
___________ (Time)
   
Departure Details  
Departure___________on
 ___________ (Date)
by
 ___________ (Train No)
___________ (Time)
   

Details of the D. D. (outstation Delegates Rs. 500, Local Delegates Rs. 300)

Amount : ___________________
D. D. Number : ___________________
Date : ___________________
Bank : ___________________

Branch :

___________________
     
Signature with Date : ______________________________________

 

   

(Make sure that you have enclosed the format duly signed, D. D. as well as the summary of the paper and a copy of the paper).

Performa may be photocopied and used.

     
PRINTED MATTER

Book-post

 
From
 To
 
Dr. (Smt) Usha R. Vijailakshmi,
 
 
Local Secretary, IHS,
 
 
Head, Department of History,
 
 
S.S.& L.S. Patkar & V.P. Varde College
 
 
S.V. Road , Goregaon (west),
 
 
Mumbai - 400 062.
 
 
 
 
Host:
S. S. & L. S. Patkar College of Arts & Science And V. P. Varde College of Commerce & Economics
S. V. Road, Goregaon (West), Mumbai - 400 062.
• Tel.: 2872 3731 / 2872 1875