HPRFM-2013 Registration

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On-line registration is mandatory for ALL participants.

Name *

Gender *

Citation *

Affiliation *

Please provide postal address of your affiliation along with pin code.

Email ID *

Please provide your email ID

Alternate E-mail ID *

Please provide an alternate email ID

Contact number *

Please provide your MOBILE number

Attending the symposium *

Preferred Presentation mode *

Please indicate your preferred mode of presentation

Accommodation *

Accompanying persons *

Please indicate number of accompanying person(s).

Accommodation range preferred *

Cost of room per night (single/double occupancy)

Travel Assistance *

A limited number of financial assistance for travel is available on a case-to-case basis (please refer to website).

Accommodation assistance *

A limited number of free accommodation will be made available on a case-to-case basis (please refer to website).

Registration Fee waiver/ rebate *

A limited number of participants will be offered waiver / rebate on the registration fee on a case-to-case basis (please refer to website).

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