Registration Form
To be filled with the payment information to confirm your registration
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
You are a
*
Please Select
Student
Research Scholar (PhD / MTech Pursuing)
Academician
Industry Professionals
Mode Of payment
*
Please Select
Bank Transfer
UPI
Transaction ID
*
Paper ID
*
Paper title
*
BRAIN Membership ID (for members)
*Fill only if you are a BRAIN member
Upload the payment confirmation page
*
Browse Files
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