Theory and Practice of Epidemiology and Biostatistics 2019
Registration form
Name of Participant *
Your answer
Designation
Your answer
Name of the Institution
Your answer
Do you have a Medical Council Registration number ? *
Required
If yes, please fill in the Medical Council Registration number and respective medical council below (eg 76890, Karnataka)
Your answer
Contact Address
Your answer
Telephone number *
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E-mail ID *
Your answer
Accommodation required
If yes, please tick choice
Agreeable to sharing room
Food preference (Participants who wish to bring own lunch during the course can pay Rs 2000/- less towards the fee)
If yes
Two main expectations from the workshop
Your answer
Will you be attending 1-day demography course?
Transaction ID of bank transfer made or DD no
Your answer
Important notes on registration
1. A separate registration form needs to be filled for each participant
2. Course fees
Before 12th June: Rs.8000/-(For Students) & 12000/- for Faculty. [After 12th June: Rs 12,000/- (for students) & Rs
17,000/- (for faculty) (plus 18% GST applicable on all fees)
2. Participants wishing to attend the 1-day demography course need to pay additional Rs 1000/- towards registration fee
3. Participants who wish to bring own lunch during the course can pay Rs 2000/- less towards the fee
4. For further clarification kindly contact Jeeva/Kavya, Telephone: 080-49467000 Ext-7030/7050
Contact for further enquiry
Dr Prem K. Mony, M.D.
Course Director
Head, Division of Epidemiology & Population Health
St. John’s Research Institute
Bangalore – 560034

Dr Tinku Thomas, PhD
Course Coordinator
Head, Biostatistics Unit
St. John’s Research Institute
Bangalore–560034
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