Indian Society of Interventional Radiology

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ISVIR2009: Registration

	Advance Reg. (up to 31st Aug)	Reg. upto 30th Sept	Reg. After 30th Sept and on the spot
Member Delegate	2000/-	3000/-	4000/-
Non-member Delegate	2500/-	3500/-	5000/-
Member Resident	1200/-	1500/-	2000/-
Non-member Resident	1500/-	2000/-	2500/-
Accopanying Person	1500/-	2000/-	3000/-

Name:
Organization / Institute:
Position:
Postal Address:
City:
State:
PIN:
Email
Tel. (Hospital.)
Tel. (Residence)
Tel. (Mobile)
Whether member of ISVIR?
Whether Prseneting Paper:	Paper Topic:
Amount Details:
Registration fee
Accompanying Guest
Total
Demand Draft No.	In favour of ISVIR-2009 Payable at New Delhi.
Drawn on bank:
Dated: