International Conference on Technological Challenges in Developing Affordable
In-Vitro Molecular Diagnostics

11- 14 March 2012
Navi Mumbai, India

REGISTRATION FORM

Name :
	Title	Surname	First Name	Middle Name
Organization :
Complete Mailing Address :
Email Id  :
Area of interest :

REGISTRATION FEE
Category	Before 31stDec. 2011	After 1st Jan 2012
Indian	Rs. 4000/-	Rs. 5000/-
Indian Students	Rs. 2000/-	Rs. 2500/-
ISSRF Members	Rs. 3500/-	Rs. 4500/-
Foreign Delegates	US$ 300	US$ 350

(Payment to be drawn in favour of “ISSRF-IVD 2012”)