INDIAN BOARD OF ALTERNATIVE MEDICINES
        18th International Congress,
Convocation & Award Presentation Ceremony
17th January 2010, Hotel Hindustan International, Calcutta

REGISTRATION FOR DELEGATES

Name:

Sex:

Male
Female

Nationality:

Qualification/Titles:

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City:

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Currency:

U.S. Dollar
Indian Rupee

Payment Details:-Bank Name:

Payment Mode:

Cheque
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Amount:

Dated:

Please tick if interested:

 I wish to read a paper on:

I wish to apply for an award. I wish to apply for M.D.(A.M.)
I wish to apply for Ph.D.(A.M.) I wish to apply for D.Sc.(A.M.)

I wish to attend the training workshop:

Pre-Congress(14, 15, 16 Jan 2010)
Post-Congress(18, 19, 20 Jan 2010)

In case of student, please type in your Roll No. and the course name, so that your certificate can be kept ready to be presented during the convocation.

The names of delegates who register themselves before 15th Dec 2003 will be published in the souvenir.

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