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Online Registration for Conference
Title
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Sur Name
:
First Name
:
Middle Name
:
Designation
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Affiliation Institution
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Mailing Address
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City
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Country
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Pin
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Tel No (O)
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Tel no (R)
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Mobile No
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Email address
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Password (for Abstract Login)
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Confirm Password
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Fax No
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Age
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Gender
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Nationality
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Passport No
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Accompanying Person's Name
(Spouse, Children over 12 years)
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Deadlines Up to
15.07.2010		 From
16.07.2010
to31.08.2010		 After 31.08.2010
& spot		 Please Choose
Registration Fee INR USD INR USD INR USD  
Conference Only-As delegate 5000 300 6000 350 7000 400
Conference Only-As student 2500 150 3000 175 3500 200
Workshop 1
CD4+/CD8+ cell count and HIV viral load estimation and their Role in AIDS monitoring
 10000 400 11000 450 N.A. -
Workshop 2
HBV & HCV Viral Load Estimation
 10000 400 11000 450 N.A.
-
Accompanying Person 2000 100 2500 125 3000 150
*PG Students need to submit a letter from the Head of the Department of their respective college / institution.
** Children over 12 years would be treated as accompanying person.
 
Payments to be made by Credit Card/DD/Banker's Cheque only, drawn in favour of "ICOPA INDIA", Payable at New Delhi.
For International Bank Transfer Details:
Name of the bank: State Bank of India, Ansari Nagar, New Delhi- 110 029, India
Bank Account No. 1087459090-8
Swift Code: SBININBB545
For Credit Card Users Pls Click on Submit Button without filling Cheque No, Date & Drawn On
I am Payig this Amount in Rs. or USD
I am sending herewith DD/Banker's Cheque No    dated   drawn on  bank, For Rs/US$ payable at New Delhi.
For Credit Card Users Pls Click on Submit Button without filling Cheque No, Date & Drawn On
Please keep a photocopy of the form for your record.