India Rising: Patient Centric Care-Integrated Approch

8th Annual Confrence

Registration Form

(Fields Marked with (*) are mandatory! )

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Male    Female
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Whether member of GAPIO

Yes       No

Note: Registration is open to all registered Medical Practitioners and Health Care Providers.
Registration fee will remain same whether attending for one day or two days.

Fee payment options :

 

For Indians: Registration fee can be deposited directly in the account and the soft copy of the Registration form and the Bank Slip can be sent to us by email on gapio.jm@gmail.com or the registration form along with DD/Chq in the name of "Global Association of Physicians of Indian Association" can be sent via surface mail to the below given address.

Registration will be confirmed only on receipt of the fee.

 

For NRI’s The fee can be collected in CASH (Rupees only) on spot at the Conference.



"Download registration form for annual conference at Mumbai"



Sponsors Application form to be sent to :

Mr. Jitendra Malik
GAPIO
Hospital Complex
Apollo Hospitals (IMCL)
Sarita Vihar, Delhi- Mathura Road
New Delhi - 110076
India
Cell: 09958767568
Email: gapio.jm@gmail.com
Bank details for Direct Deposits & Online Transfers:

Name of account: Global Association of Physicians of Indian Origin

Name of Bank: Oriental Bank of Commerce

Name of Branch: Apollo Hospitals, New Delhi, India -110076

For NEFT/ RTGS Transfer: IFSC code: ORBC0105076

SWIFT CODE: ORBCINBBIBD

Type of Account: Current Account
*Please fill up all points requested in the registration form.

Since this from is submitted online, therefore no signature is required.

Created Date

20/11/2017

Transaction Type

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Cash    Cheque

REGISTRATION CATEGORIES

EARLY BIRD

SPOT REGISTRATION

 

TILL 31ST JULY, 17

TILL 31ST OCT, 17

TILL 31ST DEC, 17

FROM 1ST JAN, 18 AND ON 6TH & 7TH JAN, 18

Member

Rs.1250

Rs.1800

Rs.2000

Rs.2500

Non-Member
(Includes Membership of GAPIO)

Rs.2500

Rs.4000

Rs.4500

Rs.5000

#Students
(Includes Membership of GAPIO)

Rs.1000

Rs.1500

Rs.2000

Rs.2500

Accompanying Person

Rs.2000

Rs.3000

Rs.3500

Rs.4000


Transaction amount * Amount to be paid in INR only

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