DNC -12 CREDIT HOURS

"Please ensure that registration fee has paid before filling registration form. You have to provide payment information while filling the online registration form."

Delegate Name: *
Surname: *
Organization: *
First Name : *
Designation: *
Category: * Faculty Staff Nurse Student
Nationality: * Indian Foreign

Mailing Address : *
City :
Mobile No. : *
Password : *
Pin code: *
Country :
Email : *
Preferred food: * Vegetarian Non-Vegetarian

*(Halal Food will be served)

PAYMENT DETAILS: (Mandatory)

Amount Paid (In Figures): *
DD No. / NEFT transaction No./ UTR No. *
Name of Bank: *
Mode of Transfer (Demand Draft/ NEFT/ Wire Transfer)
Date of Transfer (DD/MM/YY): *
Branch: *