REGISTRATION FORM


in favour of “FIAGES 2017 TVM”, Payable at Parassala is enclosed.
REGISTRATION FEES: (Please tick what is applicable)


* Documents with DD must reach conference Secretariat before this date.
ONLY CME, LIVE WORKSHOP & GALA DINNER


Residential Packages (for FIAGES Candidates)
(It includes course fee, accommodation & food from 21st july 8:00am - 23rd july 5:00 pm)



Residential Packages (for non FIAGES Delegates)



Note: Non-IAGES members cannot apply for the fellowship. They can attend the CME & Workshop only: ** Certificate from the HOD is essential for PG students.

I am not an IAGES member at present. My IAGES Membership form has been uploaded in the IAGES website. A demand draft for Rs. 7000/- drawn in favour of “lAGES-Mumbai”, payable at Mumbai is enclosed.

• RTGS / NEFT PAYMENTS DETAILS: A/C No. “3580101009334”. CANARA BANK, PARASSALA (TVM) BRANCH, IFSC Code: CNRB0003580 “. Please email scanned copy of pay in slip to “fiages2017sh@gmail.com”.
• Kindly make separate DD for IAGES membership and for the course registration.
• Cancellation policy: Refund request must be submitted in written. 50 percent refund if applied 30 days before the course. No refund thereafter. All refunds will be made 90 days after the conference.


TO BE FILLED IF ONLY APPLYING FOR FELLOWSHIP


For FIAGES: CANDIDATE MUST HAVE PASSED M.S./D.N.B. BEFORE JULY 2015 (Exam Category) and before JULY 2007
(non-exam category)

SARASWATHY HOSPITAL, PARASSALA, THIRUVANANTHAPURAM
KERALA, INDIA, PIN-695502
Tel: 0471 2202598, 2202898, 2201898 - E-mail : fiages2017sh@gmail.com, www.saraswathyinstitutions.com