HLA SSP Workshop Registration Form

For HLA workshop details, please download PDF file

Download Registration Form

Participants Particulars

*Full Name  
*Name of the Institution/Organisation
*Designation/Academic Post
*Address of the Institution/Organisation
*Tele.
Fax
*Email
   

Registration Fees

20-21st Aug, Venue : Mazumdar Shaw Centre , Bangalore

Primary Price* (Rs. 5500)         Secondary Price** (Rs. 4500)

*Single Occupancy    **Double Occupancy

The above charges are inclusive of upto 2 nights stay at an hotel close to workshop venue.
 

Payment Method : (Select whichever is applicable)
 

I wish to pay by BANK TRANSFER and would like to request an invoice
I wish to pay by Cheque (Please make the cheque payable to Biotron Healthcare India Pvt Ltd)
Cash Payment
   

Registration Details


 
1. Registration for the Conference Workshop closes on 31st July, 2010.
  2. While sending  CHEQUE/BANK DRAFT made payable to “Biotron Healthcare India Pvt Ltd” By post or
       hand, please indicate “HLA SSP Workshop” at the back of the cheque.
  3. For payment by BANK TRANSFER, please contact Mr. Sandeep at (022) 2528 7626 ext.450 or email
      sandeep@biotronhealthcare.com for detailed instruction.
  4. Registration (on or before the closing date) is confirmed upon receipt of payment, unless notified.
  5. Cancellations, transfers and refunds may be made upon receipt of written notice .

For registration enquiries, please contact : Ms. Deepa Tel: (022) 2528 7626 ext.495 Fax:(022) 2528 1012
E-mail: conferences@biotronhealthcare.com

The workshop venue is Mazumdar shaw cancer Centre, Narayana Hridulaya, Bangalore.

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