Registration Form

19 th MIDCOMS-2015
AOMSI Midterm Conference & 5 th PG Convention
th
th
09 – 11 July 2015,
Vijayawada, Andhra Pradesh.
REGISTRATION FORM
Date:
AOMSI Membership No.
Name :
Photo
Address :
City :
State:
Pin Code :
Ph :
Mobile :
Email :
Accompanying Person(s)
Name:
Age:
Gender :
Relation :
Registration Details
Category
UPTO
Jan 31
st
UPTO
March 30
th
UPTO
June 15
th
ON-SITE
*Delegates
Rs. 4000
Rs. 4500
Rs. 5000
*Delegates (Non-Member)
Rs. 5000
Rs. 5500
Rs. 6000
Rs. 7000
**PG Trainees
Rs. 3000
Rs. 3500
Rs. 4000
Rs. 5000
**PG Trainees (Non-Member)
Rs. 4000
Rs. 4500
Rs. 5000
Rs. 6000
***Accompanying Persons
Rs. 3000
Rs. 3500
Rs. 4000
Rs. 4000
* International Delegates
100 USD
150 USD
200 USD
200 USD
Rs. 6000
* Registration kit, Two Lunches, Inaugural Dinner, Gala Banquet, Gift, Entry to Scientific Sessions & Trade Exhibition
** Registration kit, Two Lunches, Inaugural High tea, Gala Banquet, Entry to Scientific Sessions & Trade Exhibition
*** Two Lunches, Gala Banquet, Entry to Trade Exhibition