2019 Workshop on International Standard

Online registration form
Prefix*
Name*
Designation*
Highest Educational Qualification*
Speciality*
If others, please specify
Lab. / Hospital / Institution*
Address with postal code*
Mobile number*
WhatsApp number
E-mail*
Alternate E-mail
example@example.com
Food preference*

VegNon-veg
Do you require accommodation in SRIHER Guest House within campus?*

YesNo
If "Yes", please write us an email to GCLP@yrgcare.org with the subject line "Accommodation Required"
Country*
Registration fee payment mode (For Indian delegates)*

NEFT / Online Bank Transfer (INR 3500)Demand draft / At par cheque (INR 3500)Outstation cheque (INR 3600)
Registration fee payment mode (For Non-Indian delegates)*

Wire Transfer (300 USD)Cash upon arrival (325 USD)
Should be Empty: