Registration Fee Payment
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STEP 1 :
Indian Delegate
Foreign Delegate
ICC Member/Non Member (Select)
*
Non Member
ICC Member
Membership No (if you are a member of ICC)
STEP 2 :
HOD LETTER / ID CARD
*
CIGI Membership No.
*
Personal Details
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STEP 2 : Personal Information
Title:
*
Mr.
Ms.
Mrs.
Dr.
Prof.
First Name:
*
Middle Name:
Last Name:
*
Affiliation:
*
Mobile No. :
Alternate Email Id:
Passport details
Passport No:
Date of Issue:
Date of Expiry:
Place of Issue:
Nationality:
Contact Information
Address:
*
Country:
*
State:
*
City:
*
Zip/Pin Code:
*
STEP 2: CONFERENCE WORKSHOP
Yes
No
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STEP 3: Details of Payment
PARTICULARS
AMOUNT
Registration Fee
Cost of Accompanying Person(s)
Banquet Cost
CGST (9%)
SGST (9%)
TOTAL COST
GST (18%)
GRAND TOTAL
3.5% Bank Charges
STEP 4: Mode of payment
Total Amount Payable:
Mode of payment
--Select Mode of Payment--
Visa / Master / Credit Card / Debit Card
NEFT / Bank Transfer / IMPS / RTGS
QR Code
Account Name
NCCS29
Account Number
43170392876
Bank Name
State Bank of India
Branch Name
NIHFW (National Institute of Health & Family Welfare)
IFSC Code
SBIN0001624
Swift Code
SBININBB548
NEFT Date
NEFT Transaction ID
Bank Name
Date
Ref. No.
Bank and Branch Name
Amount
Amount in Words
Name
In favor of:
Cheque / DD will be courier to :
Dreamz Conference Management Pvt.Ltd
218 Ansal Majestic Tower, Vikas Puri,
New Delhi - 110018
Whatapp on : +91 9810558569
Bank Name
DD/Cheque No.
DD/Cheque Date
Submit
