Home
Golf
Gala Party
Forms
links
contact us
Online Registration Form
Download form in
Pdf
format
ONLINE REGISTRATION FORM
Low income countries
*Your membership status will be verified from the list provided by IPRAS
*Choose 'Others' in the Country drop down Menu if your country is not listed as an IPRAS Member
*
Compulsory fields
Category
*
Select a Category
Faculty
Physician
Student
Nurse
Name
*
Prof.
Dr.
Mr.
Ms.
Last name
Initial
First name
Sex
:
Male
Female
Mailing Address
*
City
*
Postal code
*
State
*
Country
*
Select
Argentina
Bolivia
Bosnia and Herzegovina
Bulgaria
Chile
China
Chinese Taipei
Colombia
Costa Rica
Croatia
Cuba
Czech Republic
Dominican Republic
Ecuador
Egypt
El Salvador
Estonia
Georgia
Guatemala
Honduras
Hungary
India
Indonesia
Iran
Iraq
Jordan
Latvia
Lebanon
Lithuania
Malaysia
Mexico
Montenegro
Morocco
Nicaragua
Nigeria
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Republic Of Macedonia
Romania
Russia
Serbia
Slovak Republic
Slovenia
South Africa
Tanzania
Thailand
Tunisia
Turkey
Ukraine
Venezuela
Others
Institution
*
E mail-1
*
E mail-2
Telephones
Country code
City code
Number
Residence
Office
*
Fax
Mobile
Passport Details
(For foreign nationals only)
Number
*
Place of issue
*
Date of issue
*
Date of Expiry
*
Accompanying Persons
Number
0
1
Category
1
2
Name
Relation
Select
Spouse
Child
Passport Details
Number
Place of issue
Date of issue
Date of Expiry
Payment Details ( fill amount in Rs.)
Delegate
*
Accompanying Persons
Gala Party
Accommodation Advance
Travel & Tour
Master Class/HID
Total Amount
Separate forms for Gala Party , Travel & Tours, Master Class & Accommodation need to be filled.
All money transfer cost toward 'Tour & Accommodation' will be borne by the delegate.
I agree to accept the terms and conditions
*
29th november - 3rd december 2009
hotel ashok, new delhi
Home
|
Welcome Message
|
IPRAS Committees
|
Program at Glance
|
Call For Abstracts
|
Registration
|
Accommodation
Tours & Travels
|
Exhibition
|
Congress Location
|
General Information
|
Payment Modality
|
Links
|
Privacy Policy
|
Contact Us
Copyright IPRAS 2009.
Privacy Policy
Powered by
AERO PACK