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Isolation of Phytoconstituent Fees for the 2 day workshop is Rs. 3000/- (Rupees Three Isolation of Phytoconstituent
thousand only) (includes training aid, tea/coffee, snacks
25th and 26th March, 2017 and food, E-handout). Only 15 participants will be 25th and 26th March, 2017
registered on first cum first basis.
REGISTRATION FORM Fees does not include accommodation. However, if need
be, appropriate assistance will be provided for the same.
Name: _________________________________________
Cheque should be drawn in favor of INSTITUTE OF
Designation: _____________________________________ CHEMICAL TECHNOLOGY payable at Mumbai and sent to
the below address. Prior registration is a must and
Institute: _______________________________________
payment must be made in advance. Interested
Address: ________________________________________ participants are requested to contact the following for
registration. Last date for registration is 10th March, 2017.
_______________________________________________
Contact Details
_________________________________ Pin ________
Mr. Subodh Gangurde Mob: 9503689348
Phone No: ______________________________________
Email: subodh.gangurde007@gmail.com
Email: __________________________________________ Ms. Shefali Thakkar Mob: 8879350005
Email: pajwanis@gmail.com
Payment Details:
Medicinal Natural Product Research Laboratory,
Amount: RS. 3000 Dated: _______________ Department of Pharmaceutical Science & Technology,
Bank: _________________________________________ Institute of Chemical Technology, Nathalal Parekh Marg,
Matunga (East), Mumbai-400019.
Signature: ______________________________________ Email: ks.laddha@ictmumbai.edu.in Organized by