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ACRSICON 2022 Registration Form
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REGISTRATION FEE DETAILS
Category
*
NOTE :: PG Student - HOD's letter required for confirmation, kindly E-mail
Choose
ACRSI Member (Fees : Rs. 14,160/-)
Non-Member (Fees : Rs. 15,340/-)
PG Student* (Fees : Rs. 12,980/-)
Membership Number (mandatory for Member)
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Gender
*
Choose
Male
Female
Designation
Your answer
Institution / Hospital
Your answer
City
*
Your answer
State
*
Your answer
Mobile Number
*
Your answer
E-mail
*
Your answer
Wish to add Accompanying Person (s) ?
*
Fees : Rs. 9,440/- each
Choose
NONE
1
2
Accompanying Person(s) Detail (Name, Age, Gender)
Your answer
SCAN & PAY REGISTRATION FEES (UPI ID : merchant549711.augp@aubank)
Kindly submit your Registration Fees as per category and choice. After successful transaction, please share successful payment receipt through E-MAIL id :
acrsicon2022jaipur@gmail.com
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