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Registration Form

The document contains a registration form for NEOCON-2010, a conference and workshop being held on September 18-19, 2010 in Jamnagar, India. It requests information such as name, address, contact details, payment details. It provides information on registration fees for different categories like IAP members, post-graduates, nurses. It also lists nearby hotel accommodation options with contact numbers and provides helpline numbers for assistance during the event in Jamnagar.

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DR.MAULIK SHAH
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252 views1 page

Registration Form

The document contains a registration form for NEOCON-2010, a conference and workshop being held on September 18-19, 2010 in Jamnagar, India. It requests information such as name, address, contact details, payment details. It provides information on registration fees for different categories like IAP members, post-graduates, nurses. It also lists nearby hotel accommodation options with contact numbers and provides helpline numbers for assistance during the event in Jamnagar.

Uploaded by

DR.MAULIK SHAH
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 PDF, TXT or read online on Scribd
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NEOCON -2010, JAMNAGAR .

th th
18 & 19 September, 2010.

REGISTRATION FORM:

Name: ________________________________________________________________________________________

Adress: _______________________________________________________________________________________

_______________________________________________________________________________________

City : _______________________ Pincode:________________________

Contact no. 1.__________________________ 2. _________________________

Email : ________________________________________________________

Delegate category:  IAP Member  P.G. Student  Nurse (only for basic nursing workshop)

Payment mode :  Demand Draft no. & date:

 Cheque no. & date:

Registration:-.

Time Limits Charges

Work shop Conference

For Post Graduates 1500 1000Rs./-


st
after 31 July 2010 2000 1500Rs./-
For Nursing workshop Free -NA-
Pay by DD or Cheque in favour of “Neocon-2010,JAMNAGAR”.add Rs.50/- extra for outstation Cheque.
Workshop registration will be limited entries and served on first come first bases.
So kindly register at earliest to get your seat booked…!
Send to : Dr. Maulik Shah
associate Professor Pediatrics, Pediatrics Department,M.P.Shah Medical College, Jamnagar.

Hotel Accomodation (all are in 2.5km arena from the conference venue)

Hotel ‘AARAM ‘ ‘fortune palace’ Regency Celebration ‘President’ Punit

Contact no. 2551701-2-3 2720291-2-3-4 2661677 2662221 2557491-2-3 2558443

Helplines for any assistance at Jamnagar

Dr.Prashant Tanna Dr.Nayan Bodar Dr.Chetan Dabhi


9825681176 9924886599 9824236152

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