REGISTRATION  FORM

14TH WORLD CONGRESS OF
THE INTERNATIONAL SOCIETY FOR LASER SURGERY AND MEDICINE
27TH -30TH AUGUST, 2001  CHENNAI (MADRAS), INDIA
Please return this form to the Congress Secretariat

Please Tick : Prof  Dr. Mr. Ms.
Name :
Institution :
Mailing Address :
City : Country : Postal Code :
Tel. Home : Office : Telefax :
E-mail :

Please tick any:

REGISTRATION FEES

Category Until March 31, 2001 After April 1, 2001

No. of Persons

Total

Member US$ 400 US$ 500    
Non-Member US$ 500 US$ 600    
Nurse/Tech./Resident* US$ 100 US$ 150    
Accompanying Person US$ 100 US$ 150    
Daily Registration   US$ 100 On spot     

Fees includes 3 days of Congress Lunches, Tea, Opening Ceremony, Welcome Cocktail, Indian Cultural Nite and entry to exhibition area (bankers charges will be separate).

* A certificate of Training from Institution Head or Department Head is required.

MODE OF PAYMENT
Registration form should be accompanied by:
CREDIT CARD (VISA/MASTER)

Name :   
Number :   
Date of Expiry :   

Signature as in the Card

BANK TRANSFER : Swift Code : HSBC IN BB - A/c No. 041-152786-006, A/c NAME : DR. B. KRISHNA RAU ISLSM 2001.
DEMAND DRAFT : In favour of "Dr. B. KRISHNA RAU ISLSM 2001" Chennai.
CANCELLATION : On or before 1st June, 2001 will receive the registration fees after deducting handling charges of US$ 50. No refund thereafter.
Website :
www.medindia.net/islsm2001        Online Registration, Hotel Accommodation
PROF. B. KRISHNA RAU
President - International Society for Laser Surgery and Medicine
5, Chandra Bagh Avenue, II Street, Mylapore, Chennai - 600004, INDIA
Tel: 91-44-8527776, 8594804 Fax : 91-44-8594578 / 4767008
E-Mail :
[email protected]
Website :
www.medindia.net/islsm2001      Online Registration, Hotel Accommodation
Abstract Presentation and Payment can be done.