Conference On

Indian Medical Devices & Plastics Disposables Industry 2012

March 23 - 24, 2012

(Download Registration Form)

Registration Form

Name: _______________________________________________________________

Company:____________________________________________________________

Job Title______________________________________________________________

Address:______________________________________________________________

City:___________________________  Pin Code:_____________________________

State:___________________________ Country:_____________________________

Tel.:____________________________ Fax:_________________________________

Mobile:__________________________Email:_______________________________

Website:__________________________

I am interested in attending as follows : Kindly tick √

Student 50% discount (Limited Seats)

Your Company Products / Services :

Please find a enclosed a cheque (At Par) / DD for Rs. ___________________

Cheque No:______________________ Date:__________________________

Bank:___________________________________________________________

Authorized Signature:______________________ Date:_________________

Payment: By cheque (At par) / DD in favour of “Classic Computer Services”, payable at Ahmedabad

Online Payment:

Please follow the links below to proceed to online order form.

For Participants from India

All major credit cards processed: Visa Card, American Express, Diners Club, JCB Card, Citibank E-Card including those cards which are only valid in India and Nepal
Direct Debit facility to twelve major Bank's accounts:  HDFC Net banking account, ICICI Infinity, Citibank NRI A/C, Citibank Current A/C, Citibank Suvidha A/C, IDBI iNet banking, UTI iConnect, Centurion Bank.