Prefix*
Prof.Dr.Mr.Mrs.Ms.
Name*

Designation*
ProfessorAssociate ProfessorAssistant ProfessorScientistPost-Doctoral ResearcherDoctoral StudentOther
E-mail*

Phone*

Institution/College* (Address with PIN code)

Department*

Complete postal address with PIN code* (Where a printed book copy will be dispatched)

Title/Theme of the Book*

Sub-themes/Topics of the book*

Submission deadline for chapters*

Desired date of release of the book*

Your message (If any)

Upload your (passport-size) photograph (jpg/png)