PGD Workshop Announcement

Register here

* Indicates required field

Name *

MACE Member *

Yes No

Designation *

Organisation *

Qualification *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Registration fee - INR 1000/-
(Free for MACE Members)

Accommodation requirement (no. of days) *

Payment details *

Online bank transfer: Name of the account holder: Manipal University Conference/workshop, Manipal; Account # 33508958510, Name of the bank & address: State Bank of India, Manipal Branch, Manipal. MICR code: 576002006, IFSC code: SBIN0004426
Demand draft: Drawn in favor of ‘Manipal University conference/workshop’ payable at Manipal/ Udupi’.

Please forward the completed registration form to clinical.embryology@manipal.edu

I agree to receiving marketing and promotional materials