Registration

Last date for
Early Registration is 30th June 2010

Last date for Submission is
31st August 2010

Name (Block Letters)*

Designation/
Institution*

Correspondence Address*

Office Telephone

Residence Telephone*

Mobile Number*

Email*

Registration Fees*

Rs.

Drawn on Bank*

DD Banker's Cheque

DD Number*

DD Date*

Date*

I certify that the information given in this registration form is true, correct and complete to the best of my knowledge and belief. I agree that V.P.C.I. shall have no liability in any respect if my application is rejected on the basis of any false information furnished or omissions made by me in this registration form.

*Denotes Mandatory Fields

Registration Fees:

	Early Upto 30th June	1st July to 31st Aug.	1st Sep. to 15th Nov.	16th Nov. to Spot
Delegate	1,500/-	2,000/-	2,500/-	3,000/-
PG Student	1,000/-	1,250/-	1,500/-	1,750/-
Accompanying Person	1,000/-	1,250/-	1,500/-	1,750/-
Foriegn Delegates	USD 50/-	USD 60/-	USD 75/-	USD 100/-
Workshop Registration will be limited to 50 early registrants: Fees: Rs 1500
The registration fee for workshop on transbronchial lung biopsy interpretation is Rs 1500

All remittances must be made by Bank Draft/ Banker's cheque in favour of "POED 2010" payable at Delhi.
PG Students must send signed certificate from Head of Department.
Outstation Cheques will not be accepted.

Registration form along with DD/Banker's cheque to be sent to:

Dr. Ritu Kulshrestha
Organizing Secretary
POED 2010
Department of Pathology
Vallabhbhai Patel Chest Institute
University of Delhi
Delhi - 110007, India.

Tel: 91-11-27667102, Ext.: 114, 139
Mob: 91-09891334373
Email: ritukumar71@yahoo.com
Website: www.vpci.org.in

Important Dates