Registration Form for 10th SIOP PODC INW

Date:- 12th - 13th January 2018
Venue: R. D. Choksi Auditorium, Golden Jubilee Building, 2nd Floor, Tata Medical Hospital, Mumbai
Full Name *
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Date of Birth *
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Category *
Contact No.
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E-Mail Address *
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Designation
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Organization/Institution/University *
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Department *
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City *
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State *
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Zip/Postal Code
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Registration Fee *
Fee Payment Method *
Cheque/Demand Draft No. (If payment is other than cash) *
If Payment will be made by cash please write "Cash" below
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Questions/Requests for Fee Waivers
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Cheque or DD will be in the name of Cankids..Kidscan
Registration fee (Cash/Cheque/DD) to be submitted at the following address:
Siddharth Kamble, Asst Manager, Accounts CanKids..KidsCan, Regional Office: Jagannath Bhatankar Municipal School, Behind St.Mary's Church, Jagannath Bhatankar Marg, Parel, Mumbai 400 012, India, Tel: +91 22 2471292
Please write or Contact us at the below in case of any query
E-mail: inw2018@cankidsindia.org
Organizing Secretariat: Ms Dhanshri Pradhan (+91-8108862345)
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