Registration form for online course on Grant Management for Health Researchers
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Name (in capital letters)ย  [๐๐ฅ๐ž๐š๐ฌ๐ž ๐ฉ๐ซ๐จ๐ฏ๐ข๐๐ž ๐ญ๐ก๐ž ๐ง๐š๐ฆ๐ž ๐š๐ฌ ๐ฒ๐จ๐ฎ ๐ฐ๐จ๐ฎ๐ฅ๐ ๐ฅ๐ข๐ค๐ž ๐ข๐ญ ๐ญ๐จ ๐š๐ฉ๐ฉ๐ž๐š๐ซ ๐จ๐ง ๐ญ๐ก๐ž ๐œ๐จ๐ฆ๐ฉ๐ฅ๐ž๐ญ๐ข๐จ๐ง ๐œ๐ž๐ซ๐ญ๐ข๐Ÿ๐ข๐œ๐š๐ญ๐ž]
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Address of INSTITUTION (If you are working/studying) Address of RESIDENCE (If you are not working/studying)
If you are a St John's employee/student, please fill in your Employee/student ID. Please mail a photocopy of your St John's ID to epibio@sjri.res.inย to process your application further.
If you are a doctor, please fill in your Medical Council Registration number
๐Œ๐Ž๐ƒ๐„ ๐Ž๐… ๐๐€๐˜๐Œ๐„๐๐“ :ย  ๐๐ฅ๐ž๐š๐ฌ๐ž ๐ง๐จ๐ญ๐ž ๐ญ๐ก๐ž ๐œ๐จ๐ฎ๐ซ๐ฌ๐ž ๐Ÿ๐ž๐ž ๐ข๐ฌ ๐ญ๐จ ๐›๐ž ๐ฉ๐š๐ข๐ ๐ž๐ข๐ญ๐ก๐ž๐ซ ๐ญ๐ก๐ซ๐จ๐ฎ๐ ๐ก ๐๐„๐…๐“/๐ˆ๐Œ๐๐’ ๐ญ๐ซ๐š๐ง๐ฌ๐Ÿ๐ž๐ซ. ๐๐ฅ๐ž๐š๐ฌ๐ž ๐๐จ ๐ฆ๐š๐ข๐ฅ ๐ฎ๐ฌ ๐š ๐œ๐จ๐ฉ๐ฒ ๐จ๐Ÿ ๐๐„๐…๐“ ๐ญ๐ซ๐š๐ง๐ฌ๐Ÿ๐ž๐ซ ๐ˆ๐ƒ ๐š๐Ÿ๐ญ๐ž๐ซ ๐ญ๐ก๐ž ๐ญ๐ซ๐š๐ฌ๐š๐ง๐œ๐ญ๐ข๐จ๐ง.
Please CHOOSE CORRECT FEE CATEGORY below and make a NEFT or IMPS Payment for the amount. Once you make the payment, please send us your TRANSACTION details.

Category 1 โ€“ You are aย St John's employee/student
Total Fee โ‚น1180 (Course fee 1000 +18% GST 180)

Category 2 โ€“ย You are aย external participant
Total Fee โ‚น2301 (Course fee 1950 +18% GST 351)

Category 3 โ€“
For participants from outside India: US $ 50/- ( fifty US dollars only)

Kindly transfer this amount to the Bank Accounts details mentioned below. PLEASE DO NOT FORGET TO MAIL THE TRANSACTION DETAILS WITH YOUR NAME TO epibioonline@gmail.com

Account Holder ST.JOHNโ€™S RESEARCH INSTITUTE
Account Type Current Account
Account No. 05210100024920
IFSC Code BARB0STJOHN
MICR Code 560012009
Swift Code BARBINBBBGL
Bank Bank of Baroda, Johnnagar branch, St. John medical college campus,koramangala,bangalore-560034, Karnataka
Branch Name JOHNNAGAR BRANCH

***once you make the payment ๐ƒ๐Ž ๐๐Ž๐“ ๐…๐Ž๐‘๐†๐„๐“ ๐“๐Ž ๐‚๐‹๐ˆ๐‚๐Š ๐“๐‡๐„ย ๐’๐”๐๐Œ๐ˆ๐“ ๐๐”๐“๐“๐Ž๐ย ๐“๐Ž ๐’๐„๐๐ƒ ๐”๐’ ๐“๐‡๐„ ๐‘๐„๐†๐ˆ๐’๐“๐‘๐€๐“๐ˆ๐Ž๐ ๐ƒ๐„๐“๐€๐ˆ๐‹๐’

๐๐ฅ๐ž๐š๐ฌ๐ž ๐ฆ๐š๐ข๐ฅ ๐ญ๐ก๐ž ๐ญ๐ซ๐š๐ง๐ฌ๐š๐œ๐ญ๐ข๐จ๐ง ๐ˆ๐ƒ ๐ญ๐จ ๐ž๐ฉ๐ข๐›๐ข๐จ๐จ๐ง๐ฅ๐ข๐ง๐ž@๐ ๐ฆ๐š๐ข๐ฅ.๐œ๐จ๐ฆ ๐ญ๐จ ๐œ๐จ๐ง๐Ÿ๐ข๐ซ๐ฆ ๐ฒ๐จ๐ฎ๐ซ ๐ซ๐ž๐ ๐ข๐ฌ๐ญ๐ซ๐š๐ญ๐ข๐จ๐ง.


๐‚๐Ž๐๐“๐€๐‚๐“ ๐…๐Ž๐‘ ๐„๐๐๐”๐ˆ๐‘๐˜ :

๐…๐จ๐ซ ๐Ÿ๐ฎ๐ซ๐ญ๐ก๐ž๐ซ ๐œ๐ฅ๐š๐ซ๐ข๐Ÿ๐ข๐œ๐š๐ญ๐ข๐จ๐งย 
๐ค๐ข๐ง๐๐ฅ๐ฒ ๐œ๐จ๐ง๐ญ๐š๐œ๐ญย  ๐Œ๐ซ ๐Ž๐ฌ๐ก๐š๐งย ย ๐๐ก: ๐ŸŽ๐Ÿ–๐ŸŽ-๐Ÿ’๐Ÿ—๐Ÿ’๐Ÿ”๐Ÿ•๐ŸŽ๐ŸŽ๐ŸŽ ๐„๐ฑ๐ญ-๐Ÿ•๐ŸŽ๐Ÿ‘๐ŸŽ


๐ƒ๐ซ ๐๐ซ๐ž๐ฆ ๐Š. ๐Œ๐จ๐ง๐ฒ, ๐Œ.๐ƒ.
๐‚๐จ๐ฎ๐ซ๐ฌ๐ž ๐ƒ๐ข๐ซ๐ž๐œ๐ญ๐จ๐ซ
๐‡๐ž๐š๐, ๐ƒ๐ข๐ฏ๐ข๐ฌ๐ข๐จ๐ง ๐จ๐Ÿ ๐„๐ฉ๐ข๐๐ž๐ฆ๐ข๐จ๐ฅ๐จ๐ ๐ฒ & ๐๐จ๐ฉ๐ฎ๐ฅ๐š๐ญ๐ข๐จ๐ง ๐‡๐ž๐š๐ฅ๐ญ๐ก
๐’๐ญ. ๐‰๐จ๐ก๐งโ€™๐ฌ ๐‘๐ž๐ฌ๐ž๐š๐ซ๐œ๐ก ๐ˆ๐ง๐ฌ๐ญ๐ข๐ญ๐ฎ๐ญ๐ž
๐๐š๐ง๐ ๐š๐ฅ๐จ๐ซ๐ž โ€“ ๐Ÿ“๐Ÿ”๐ŸŽ๐ŸŽ๐Ÿ‘๐Ÿ’

๐ƒ๐ซ ๐“๐ข๐ง๐ค๐ฎ ๐“๐ก๐จ๐ฆ๐š๐ฌ, ๐๐ก๐ƒ
๐‚๐จ๐ฎ๐ซ๐ฌ๐ž ๐‚๐จ-d๐ข๐ซ๐ž๐œ๐ญ๐จ๐ซ
๐‡๐ž๐š๐, ๐๐ข๐จ๐ฌ๐ญ๐š๐ญ๐ข๐ฌ๐ญ๐ข๐œ๐ฌ ๐”๐ง๐ข๐ญ
๐’๐ญ. ๐‰๐จ๐ก๐งโ€™๐ฌ ๐‘๐ž๐ฌ๐ž๐š๐ซ๐œ๐ก ๐ˆ๐ง๐ฌ๐ญ๐ข๐ญ๐ฎ๐ญ๐ž
๐๐š๐ง๐ ๐š๐ฅ๐จ๐ซ๐žโ€“๐Ÿ“๐Ÿ”๐ŸŽ๐ŸŽ๐Ÿ‘๐Ÿ’

๐ƒ๐ซ ๐Š๐š๐ฏ๐ฒ๐š ๐‘, ๐Œ๐๐‡
๐‚๐จ๐ฎ๐ซ๐ฌ๐ž ๐‚๐จ-๐จ๐ซ๐๐ข๐ง๐š๐ญ๐จ๐ซ
๐ƒ๐ข๐ฏ๐ข๐ฌ๐ข๐จ๐ง ๐จ๐Ÿ ๐„๐ฉ๐ข๐๐ž๐ฆ๐ข๐จ๐ฅ๐จ๐ ๐ฒ & ๐๐จ๐ฉ๐ฎ๐ฅ๐š๐ญ๐ข๐จ๐ง ๐‡๐ž๐š๐ฅ๐ญ๐ก
๐’๐ญ. ๐‰๐จ๐ก๐งโ€™๐ฌ ๐‘๐ž๐ฌ๐ž๐š๐ซ๐œ๐ก ๐ˆ๐ง๐ฌ๐ญ๐ข๐ญ๐ฎ๐ญ๐ž
๐๐š๐ง๐ ๐š๐ฅ๐จ๐ซ๐ž โ€“ ๐Ÿ“๐Ÿ”๐ŸŽ๐ŸŽ๐Ÿ‘๐Ÿ’

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