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Gujarat State Head & Neck Oncology 4th Annual Conference 19 – 20th February 2011
Organizing Chairman: Dr. Girish Mishra Professor & Head Dept of ENT & Head - Neck Services Karamsad – Anand. Under Auspcies of : M.S.Patel Cancer Centre Shree Krishna Hospital Karamsad - Anand Venue : Madhubhan Resort & Spa
Dear Colleagues, It gives us a great pleasure inviting you all at the 4th Annual Conference Meet of Gujarat Society of Head and Neck Oncology (G-SHNO) to be held this time in Karamsad, Anand on 19th and 20th February, 2011 at Madhubhan Resort and Spa. The main highlights of this event will be • High level of scientific feast with reputed national and international (upon confirmation) faculties. • More interactive sessions with enough opportunities to interact with the faculties. • Sessions include invited and guest lectures, panel, debates, poster presentation, surgical video presentation. • The conference will be preceded by a pre-conference CME on “Introduction to Head and Neck” for the upcoming head and neck surgeons and residents interested to peruse carrier in head and neck oncology. • Interesting video presentations with interactive session. We look forward for your active participation in the milk city of India, Anand.
Organising Chairman Dr. Girish Mishra Organsing Secretary Dr.Siddharth Shah Treasurer Dr. Yojana Sharma
Name of the Delegate: Address: PIN Code: Mobile: Kindly register me for the Head & Neck Oncology on E-mail ID: Land line: and arrange accommodation at Madhubhan Resort as SINGLE/TwIN OCCUPACY Registration for CME Status Consultants PG’s Registration charges Rs.1000/20USD Rs. 500
Registration with accommodation Early bird Till Nov. 30th, 2010 Consultants Spouse Registration without accommodation Early bird Till Nov. 30th, 2010 Consultants PG’s Spouse Hotel check in - 19th February 2011 at 12.00 p.m. Rs. 3,500/75USD Rs. 2,500/50USD Late 1st Dec.2010 to 10th Spot February,2010 Rs. 4,000/80USD Rs. 3,000/60USD Rs.2,000/40USD Check out: 20th February 2011, 12.00 noon Rs.5,000/100 USD Rs.4,000/80USD Rs.6,500/150 USD Late 1st Dec. 2010 to 10th February, 2010 Rs.7,500/ 180 USD Rs.3500/75USD Spot Rs.9,000/ 200 USD
Mode of Payment:
D/D/ or Local Cheque or At Par payable Cheque or wire transfer. ** Cheques / DD’s should be drawn in favor of “Charutar Arogya Mandal” D/D No: Branch: Account Name Account No. Branch code - 5099 Bank Name & Address IFSC Code All the columns should be filled in capital letters. Currency: Rupees for Indian nationals and US Dollars for Foreign nationals. Delegate Signature * Delegate can scan the filled Registration / Accomodation form. Food Preference : Veg. Non-Veg. Jain : : : : Charutar Arogya Mandal 50992010007030 Oriental Bank of Commerce, Ext. Branch Karamsad, ORBC0105099 / wire transfer ref no.: City:
Your Bank Name: For wire transfer:
Address for Correspondence: Dr. Siddharth Shah Dept. of ENT & HEAD and NECK Surgery Gokal Nagar, Karamsad - 388 325, Gujarat (India) Ph: +91 2692 228133,228130 Mob: 9726579818 Email: email@example.com or firstname.lastname@example.org
The conference fee includes following: • • • • • • • • Accommodation on twin sharing basis at Madhubhan Resort and Spa All complementary services provided by the resort. Entry to all sessions of the conference Conference kit 2 lunch, tea/coffee,1 banquet,1 breakfast and a cultural feast. PG/Resident Doctors are required to submit a bonafide certificate/letter duly signed by the HOD/Head of Institute at time of entering conference The PG accommodation is not included in the registration fees for the conference and CME. The conference fee does not include anything that is not explicitly mentioned under “ conference inclusions”.
Conference terms and conditions:
Registration payment terms and conditions: • For all early bird registrations, payment must be received by 30th Novemeber 2010 • For all other registrations, payment must be received by 10th February,2011 • Please be advised that your registration is not considered confirmed until payment has been received in full. Registration cancellation policy • All cancellation must be received in writing with due reason. • Registration cancellation for the summit will not be accepted by telephone. • 25% of the registration fees will be deducted against cancellation as administration charge up to 10th Feb. 2011 • Cancellation received after this date will not be liable for a refund.