Registration Form

Membership No.

MCI Registration No.

State Of Registration:

Registration No:

Receipt No.

Personal Details:

Dr. Prof. Mrs. Mr.

First Name

Last Name

Gender

Male Female

Designation:

Institution:

Address:

City:

State:

Country:

Pin:

Telephone:

Mobile:

E-mail:

Accompanying Person Name:

Use Coupon #FIRST150 to get FREE registration before 28th March

Apply for Lifetime Member (at just Rs.3000)

Yes No

Cardiabcon 2024 - Registration Grid

Conference Registration Fee

Date
(Upto)

Delegate
⟨₹⟩

Accompaying
⟨₹⟩

International Delegates ⟨$⟩

Post Graduate Students ⟨₹⟩

Paramedical / Hospital Staff

29th Feb

2,000 INR

1,000 INR

$18

1,000 INR

500 INR

5th March

2,500 INR

1,500 INR

$25

1,500 INR

500 INR

15th March

3,000 INR

2,000 INR

$30

1,500 INR

500 INR

25th March

3,500 INR

2,000 INR

$35

2,000 INR

500 INR

On-Spot

4,500 INR

2,500 INR

$50

2,500 INR

500 INR

Cardiabcon 2024 - Registration Grid

Conference Registration Fee

Delegate ⟨₹⟩

Date (Upto)

Price

29th Feb

2,000 INR

5th March

2,500 INR

15th March

3,000 INR

25th March

3,500 INR

On Spot

4,500 INR

Accompaying ⟨₹⟩

Date (Upto)

Price

29th Feb

1,000 INR

5th March

1,500 INR

15th March

2,000 INR

25th March

2,000 INR

On Spot

2,500 INR

International Delegates ⟨$⟩

Date (Upto)

Price

29th Feb

$18

5th March

$25

15th March

$30

25th March

$35

On Spot

$50

Post Graduate Students ⟨₹⟩

Date (Upto)

Price

29th Feb

1,000 INR

5th March

1,500 INR

15th March

1,500 INR

25th March

2,000 INR

On Spot

2,500 INR

Paramedical / Hospital Staff ⟨₹⟩

Date (Upto)

Price

29th Feb

2,000 INR

5th March

2,000 INR

15th March

2,000 INR

25th March

2,000 INR

On Spot

2,000 INR

Workshop Registration Fee

Date
(Upto)

Delegate
⟨₹⟩

Accompaying
⟨₹⟩

International Delegates ⟨$⟩

Post Graduate Students ⟨₹⟩

Paramedical / Hospital Staff

29th Feb

1,500 INR

700 INR

$15

800 INR

500 INR

5th March

2,000 INR

1,000 INR

$20

1,000 INR

500 INR

15th March

2,500 INR

1,000 INR

$20

1,500 INR

500 INR

25th March

3,000 INR

1,000 INR

$30

1,500 INR

500 INR

On-Spot

4,000 INR

1,000 INR

$50

2,000 INR

500 INR

Workshop Registration Fee

Delegate ⟨₹⟩

Date (Upto)

Price

29th Feb

1,500 INR

5th March

2,000 INR

15th March

2,500 INR

25th March

3,000 INR

On Spot

4,000 INR

Accompaying ⟨₹⟩

Date (Upto)

Price

29th Feb

700 INR

5th March

1,000 INR

15th March

1,000 INR

25th March

1,000 INR

On Spot

1,000 INR

International Delegates ⟨$⟩

Date (Upto)

Price

29th Feb

$15

5th March

$20

15th March

$20

25th March

$30

On Spot

$50

Post Graduate Students ⟨₹⟩

Date (Upto)

Price

29th Feb

800 INR

5th March

1,000 INR

15th March

1,500 INR

25th March

1,500 INR

On Spot

2,000 INR

Paramedical / Hospital Staff ⟨₹⟩

Date (Upto)

Price

29th Feb

500 INR

5th March

500 INR

15th March

500 INR

25th March

500 INR

On Spot

500 INR

Payment Methods:

All Cheque/ DD drawn in favor of “Cardiabcon Society” payable at Varanasi and send it to conference secretariat.
Transfer the registration fee using following Bank Details:

Account Name – Cardiabcon Society
Bank Name – Bank of Baroda
A/C NO – 27790-200000-437
Branch Name – IMS, BHU, Varanasi
IFSC Code: BARBOBHUVAR

Conference Secretariat:
Dr. Ashutosh Mishra
B 34/131 K-8-C, Gayatri Nagar, Shukulpura, Varanasi
PIN-221010

To Avail Discount for Group Registration in any Category Apply Coupon Code

COUPONCODE/CARDIABCON50% | 10 to 20 Registration)
COUPONCODE/CARDIABCON60% (21 to 30 Registration)
COUPONCODE/CARDIABCON 70% (30 & above Registration)