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Committee Memership

The document is an application form for membership on the organizing/technical program committee of the ICITA 2022 International Conference on Information Technology and Applications. The form requests applicant name, date of birth, qualifications, experience, department/college details, contact information, research interests, and agreement to ICITA's constitution and code of ethics. Signatures are also required.

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Fazlee Kan
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26 views2 pages

Committee Memership

The document is an application form for membership on the organizing/technical program committee of the ICITA 2022 International Conference on Information Technology and Applications. The form requests applicant name, date of birth, qualifications, experience, department/college details, contact information, research interests, and agreement to ICITA's constitution and code of ethics. Signatures are also required.

Uploaded by

Fazlee Kan
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Application Form for Membership of Organizing/Technical Program Committee (Faculty Level of !C"# !nternational Conference on !

nformation Technology an$ Applications %&'( (!C"#)!C!TA *'(


Title (Dr,Mr.Ms, etc) Full Name Date of Birth (DD-MM-YYYY) Qualification Designation Ex erience (in Years) De artment !ollege"#ni$ersit% &''ress of the !ollege"#ni$ersit% (ostal")i !o'e *tate"(ro$ince !ountr% (rimar% Email &''ress *econ'ar% Email &''ress !ontact Num+er !ell Num+er *,% e -' Face+oo, -' Ma.or Fiel' (/esearch -nterest) * ecific /esearch -nterest &re %ou mem+er of -!/0 (Yes" No) - here+% a l% for 1111111111111111111111111111 Mem+ershi of 2rgani3ing"Technical (rogram !ommittee(Facult% 4e$el) of -!/0 -nternational !onference on -nformation Technolog% an' & lications 5678 (-!/0--!-T& 978) an' agree to +e go$erne' +% the -!/0 !onstitution, B%la:s, an' !o'e of Ethics. - un'erstan' that -!/0 :ill communicate :ith me regar'ing m% in'i$i'ual mem+ershi an' all relate' +enefits.

+ame

,ate

Application Form for Membership of Organizing/Technical Program Committee (-tu$ent Level of !C"# !nternational Conference on !nformation Technology an$ Applications %&'( (!C"#)!C!TA *'(
Title (Dr,Mr.Ms, etc) Full Name Date of Birth (DD-MM-YYYY) *tu'ent of (B*"M*"(hD, etc) /egistration Num+er *emester De artment !ollege"#ni$ersit% &''ress of the !ollege"#ni$ersit% (ostal")i !o'e *tate"(ro$ince !ountr% (rimar% Email &''ress *econ'ar% Email &''ress !ontact Num+er !ell Num+er *,% e -' Face+oo, -' Ma.or Fiel' (/esearch -nterest) * ecific /esearch -nterest &re %ou mem+er of -!/0 (Yes" No) - here+% a l% for 1111111111111111111111111111 Mem+ershi of 2rgani3ing"Technical (rogram !ommittee (Facult% 4e$el) of -!/0 -nternational !onference on -nformation Technolog% an' & lications 5678 (-!/0--!-T& 978) -!/0 an' agree to +e go$erne' +% the -!/0 !onstitution, B%la:s, an' !o'e of Ethics.- un'erstan' that -!/0 :ill communicate :ith me regar'ing m% in'i$i'ual mem+ershi an' all relate' +enefits. Name Date

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