REGISTRATION FORM
Kindly submit your Registration Fees as per category and choice. After successful transaction, please share successful payment receipt on E-MAIL id : jsmedicalcharitabletrust@gmail.com

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REGISTRATION FEES
NOTE

* PG Student must send a recommendation letter from HOD of the Institute

•Conference Registration is mandatory for attending Hands-on Training on Models Session.
•Single Occupancy accommodation available at Venue for 2 nights / 3 days (Check-in : Friday 10th May, 2024 | Check-out: Sunday 12th May, 2024) @ Rs. 3,000/-. If you are interested, kindly add the amount in the Registration Fees charges.
•Check-in Time: 1400 hrs. and Check-out Time: 1200 hrs.
•Limited rooms available, rooms availability on subject to first come first serve basis.
Registration Category
 *
ISCP Fellowship Exam will be held on 12th May, 2024 at 6.00 am
Title *
First Name
 *
Middle Name
Last Name
 *
Gender *
Designation
Institution / Hospital
City *
State *
Mobile *
E-mail *
Wish to attend Hands-on Training Session ? *
- Conference Registration is mandatory for attending Hands-on Training Session.
 Additional Fees : Rs. 1,500/- till 10th May, 2024
Wish to add Accompanying Person(s)  *
Accompanying Person(s) Detail (Name, Age, Gender)
BANK ACCOUNT DETAILS
Account Name : J.S. Medical Charitable Trust
Current Account Number : 60280788751
Bank : Bank of Maharashtra
Branch : Vidyadhar Nagar, Jaipur
IFS Code : MAHB0001360
SCAN & PAY REGISTRATION FEES  (ALL-IN-ONE QR CODE)
Kindly submit your Registration Fees as per category and choice. After successful transaction, please share successful payment receipt on E-MAIL id : jsmedicalcharitabletrust@gmail.com
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