The Society of Cosmetic Surgeons
REGISTRATION FORM Name: __________________________________________________ Age: _______Sex: _______ Designation:____________________ Institution: _______________________________________ Mailing Address: ________________________________________________________________ ______________________________________________________________________________ ____________________City: __________ State: ________________________Pin:___________ Membership No.(Life Member): _______________ Mobile No.:______________________Email ID: (Mandatory):_____________________________ Accompanying Person No: ___________________________ 1.Name: _________________________ Age: _______Sex: _______ 2.Name: _________________________ Age: _______Sex: _______ REGISTRATION FEE: Conference Accompanying person
Workshop Banquet 1 Day Hotel(Radisson) deposit Total TOTAL AMOUNT:( IN WORDS) :____________________________________________________ Payment Mode: Cash/Cheque/Demand Draft / Bank Transfer Cheque/ D.D./ NEFT No. :___________________ Dated Drawn on: ______________________ Favoring “The Society of Cosmetic Surgeons” payable in Mumbai. BANK DETAILSName of Bank- HDFC Bank Account name and no.- The Society of Cosmetic Surgeons, A/c no.00601450001093 Branch code/ IFSC code-HDFC0000060 Branch Address-HDFC, Fort MUMBAI, 400001 Page 1 of 2
REGISTRATION FORM HOW TO REGISTER? • Direct Post- Download the registration form from the website www.iscs.in, fill it up and send the completed form along with the registration fees by DD/ Cheque to the conference secretariatThe Cosmetic Surgery Institute 8th Floor, Mangalmurthi CHS, Linking Road, Santacruz west Mumbai - 400054 • Online registration -log on to conference website. Fill up the online registration form and pay by Internet bank transfer. Please inform us your NEFT details by email. Phone: 022-67337500/26617575, Help line No. 09870155540 Email: info@iscs.in CANCELLATION AND REFUND POLICY: • Cancellation on or before 31st July, 2017- 50% of Registration fees will be deducted • No refund for cancellation after 31st July, 2017. All refunds will be made after the conference by HDFC Bank cheque only. For more details please contact the Conference secretariat by email or a phone call.
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