Registration Fee Payment
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STEP 1 :
Indian Delegate
Foreign Delegate
Personal Details
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STEP 2 : Personal Information
Title:
*
Mr.
Ms.
Mrs.
Dr.
Prof.
First Name:
*
Middle Name:
Last Name:
*
Affiliation:
*
Mobile No. :
Alternate Email Id:
Passport details
Passport No:
Date of Issue:
Date of Expiry:
Place of Issue:
Nationality:
Contact Information
Address:
*
Country:
*
State:
*
City:
*
Zip/Pin Code:
*
STEP 2: Pre Workshop On 16 Oct
Workshop
Yes
No
Select
Workshop
Workshop not available
Cadaveric Course
Robotics Training
Post Graduate CME
STEP 3: Accompanying Person Details
Accompanying Person
--Select Person--
0
1
2
3
4
STEP 4: Details of Payment
PARTICULARS
AMOUNT
Registration Fee
Pre Workshop Fees
Cost of Accompanying Person(s)
Banquet Cost
CGST (9%)
SGST (9%)
TOTAL COST
GST (18%)
GRAND TOTAL
3.5% Bank Charges
STEP 5: Mode of payment
Total Amount Payable:
Mode of payment
Visa / Master / Credit Card / Debit Card
Account Name
DREAMZ CONFERENCE MANAGEMENT PVT LTD
Account Number
629605011336
Bank Name
ICICI Bank Ltd
Branch Name
Vikaspuri,New Delhi.110018
Neft/RTGS/IFSC Code
ICIC0006643
NEFT Date
NEFT Transaction ID
Bank Name
In favor of:
Cheque / DD will be courier to :
Dreamz Conference Management Pvt.Ltd
218 Ansal Majestic Tower, Vikas Puri,
New Delhi - 110018
Whatapp on : +91 9810558569
Bank Name
DD/Cheque No.
DD/Cheque Date
Submit
