IAPCON

Preconference workshop Registration


Direct Fund Transfer

Once the payment has been made, please complete the registration form below to register.


Cheque or DD

Alternatively you can draw a cheque or DD in favour of IAPCON COIMBATORE 2017 payable at Coimbatore and send it with completed registration form to the given below address. The registration form is in microsoft word format. If you are unable to use it please download the PDF version and submit all the required information required. An email with the registration number will be sent to you once the cheque or DD has been realized.

IAPCON 2017, VN Cancer Centre,
P.N.Palayam, Coimbatore - 641037.
Tamil Nadu, INDIA


Registration Form


Are you an IAPC member? 

Yes No

Delegate Category 


Preconference workshop title 


preconference Registration Fees 


PERSONAL INFORMATION


salutation 


Country 


PAYMENT DETAILS

Please fill the following fields after you transfer the payment.
Registration can be confirmed only after we realize the payment.

* Once the form is submitted you will receive an acknowledgement email initially. Once the payment is realised, a further confirmation email will be sent along with your registration number. Kindly refer to your registration number for all future correspondence.