14TH WORLD CONGRESS
OF THE
INTERNATIONAL SOCIETY FOR LASER SURGERY AND MEDICINE
ORGANISED BY :  THE INDIAN ASSOCIATION OF LASER SURGERY AND MEDICINE
27 - 30th AUGUST, 2001, CHENNAI, INDIA
SPONSORSHIP / EXHIBITION APPLICATION FORM
 
Company Name *
Address *
Country
City *
Telephone
Telefax
Person to Contact *
Position in Company *
EXHIBITION REQUIREMENTS
Booth(s) No. *
PRODUCTS TO BE EXHIBITED
Please specify *
PAYMENTS
Rental fee must accompany with deposit of 50% fee per booth booked. Payments should be made through Cheque / Bank Draft, drawn in  favour of  "Dr. B.KRISHNA RAU ISLSM 2001, CHENNAI".
Cheque / Bank Draft No. *
Amount (U.S.$) *
Name of the Bank *
Dated *
Country
Exhibitor Names 1.
2.
3.
Note: * Fields are mandatory
Please return this copy to :  THE CONGRESS SECRETARIAT,
                                       Department of Surgery - D2 Ward,
                                       Sri Ramachandra Medical College & Research Institute,
                                       Porur, Chennai (Madras) - 600 116. INDIA
                                       Phone : 91-44-4765856    Fax : 91-44-4767008