8 th Asia Pacific Plasma Theory Conference
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Pre-Registration Form

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First Name:*
(as in Passport)
Middle Name:
(if in Passport)
Family Name: *
(as in Passport)
Institutional Affiliation
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City: *
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Phone: *
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Fax:
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Nationality: *
Date of Birth dd/mm/yy: *
Sex M/F:
Passport No:
(Type NA in case of no passport) *
Place of Issue of Passport:
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Date of expiry of Passport:
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(dd/mm/yy)
City for Visa application:
(where there is an Indian Embassy)
Oral Presentation ?

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