Registration Form - 44th CMAI Biennial Conference
Dear Friends,

CMAI members come together once every two years for fellowship, to exchange professional experiences and to plan its activities across the country. The next Biennial Conference will be organised at LA Lawns, Bhubaneswar, Odhisha from 5 – 8 November 2017. CMAI member institutions and sponsors will be allotted space for exhibition stalls.

This will be a wonderful time of fellowship as Christian health professionals to renew, revisit and reinvigorate ourselves for the future. As members of the Association, please participate and make this event a fruitful one.

On this occasion, we are also bringing out a souvenir, which will have articles by individuals and institutional members. This publication, as in the past, has a long shelf life, since the members cherish their long history of fellowship and reunion. The advertising tariff is mentioned in this brochure. I invite you to advertise in the souvenir, reserve stalls as well as participate in this memorable event.

Email address *
Name *
Your answer
Date of Birth
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Age *
Your answer
Sex *
Are you a member of CMAI *
CMAI Membership No
Your answer
Profession *
Your answer
Institution *
Your answer
Address Line 1 *
Your answer
Address Line 2
Your answer
District *
Your answer
State *
Your answer
Pincode *
Your answer
Phone no
Your answer
Mobile no *
Your answer
Meal preference *
I am coming by
Arrival Date
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Arrival Time
Time
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Departure Date
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Departure Time
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Departure Time
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Departure Time
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Registration and Conference fees
Registration Fees *
Required
Conference Fees *
Required
Preferred payment mode *
Payment details
The payment can be sent as a cheque/ demand draft in favour of CMAI along with the completed registration form.

Online payments can be made through CMAI website Go to - Support - Donation. (http://cmai.org/support/)

Direct payment can be made with the use of IFSE Code as given below.

Account Name: CHRISTIAN MEDICAL ASSOCIATION OF INDIA
Bank: INDIAN BANK
Account No: 424514710
Account type: SAVINGS BANK ACCOUNT

Kindly intimate online transfer of registration by email at cmai@cmai.org

Looking forward to this time of fellowship at Bhubaneswar!


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