Manual Registration System for SANCON 2018
This form is to be submitted only once. Sending multiple entries may invalidate the whole process of submission. So, please be careful while submitting this form. Enter the valid and working email address and phone number that you would like to be contacted through in the respective section. Thank you for your co-operation.

Click here for the detail information regarding registration types: https://goo.gl/wjsuUf

Note: The last date for late registration is until 12:00 AM, 17th March 2018. After that period, only SPOT registration will be open. We thank you all for your overwhelming response and co-operation.

Registration Sub-Committee
19th SANCON Organizing Committee

You can scan the following QR Code and directly enter the details from your handheld device.
https://docs.google.com/forms/d/e/1FAIpQLSdO5mLSZiDTzVp1FOKXb6l_MuqpHjQZBWrVyZ5wVUpi1XT92A/viewform
Please check one that is applicable to you *
Note: Associate Members and Residents are required to submit a scanned copy of "Bonafide Certification from the Head of Department of the concerned institute". The format is available here: https://goo.gl/fhBdyg
First Name *
This will also be used to print your badge.
Your answer
Last Name *
This will also be used to print your badge.
Your answer
Email Address *
Important to receive updates regarding registration from us.
Your answer
Current Institution of work
Your answer
Nationality
Designation
Your answer
Address for correspondence
Your answer
Name of accompanying person (only one and if applicable only)
Accompanying person from SAARC and Non SAARC delegate will be charged 50% of the registration fee (Conference Bags/Accessories will not be provided for the accompanying persons)
Your answer
Payment type *
Click here if you want to pay through esewa: https://goo.gl/i6KAMV. Please make a fund transfer to: Esewa ID: 9841397587; Enter the desired amount and Details as: Your name; and state whether it is for conference only or conference and workshop both. Click here to see an instruction for fund transfer in esewa: https://goo.gl/uNSGGr. Click here for details about bank accounts of SAN: https://goo.gl/JMdjqd. Note: ANY ADDITIONAL COSTS ACCRUED DURING PAYMENT TRANSFER IS TO BE BORNE BY THE REGISTRANT HIM/HERSELF.
Total Amount Paid (NRs)
Enter the total amount paid for including conference and workshop.
Your answer
Please enter the following: Receipt number (if paid in cash), Bank name (for bank deposit), or Transaction ID (for payment through e-sewa)- whichever is applicable, in the space below *
This is where you will find the transaction ID in esewa: https://goo.gl/QQAmeG
Your answer
Select the name of the person you paid cash to:
Payment for (The workshop registration is now closed) *
Enter you phone number *
Your answer
Any special request?
Regarding meals, access to the conference, or any other messages.
Your answer
Please scan and email the following two documents (if applicable) to the conference email address: nepalanesthesiologists@gmail.com
You will receive a confirmation email from the registration sub-committee once we receive and verify the documents.
Please rate us with your overall experience in the new Open Conference System (OCS) and registration system
Worst
Best
Please give us suggestions and feedbacks regarding OCS and this change in registration system.
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms