Dear All,
For the REGISTRATION & ACCOMODATION FORM send in a request email at
peo.msb@gmail.com and we will email it within a day's time.
Alternatively you could SMS your email id at the mobile numbers mentioned on the introduction page with your name and college name.
Registration Fees is Rs 100 for each event.
All the team members have to register individually for the technical event for the entry to be considered.
Each student can submit a maximum of three abstract with the same or different team mates
For registration in more than two events the amount fixed is
Rs 300.
(eg.Rs 300 for three, four or in all five events)
You have to pay the amount via DEMAND DRAFT issued in the favour of "INDIAN PHARMACEUTICAL ASSOCIATION - MAHARASHTRA STATE BRANCH" to take part in the Rx TECHNICAL SYMPOSIUM ( irrespective of the number of event you intend to take part) upto 18th JANUARY 2011.
ABSTRACTS SUBMITTED AFTER MIDNIGHT OF 18th JANUARY 2011 WILL NOT BE ACCEPTED.
The students will be intimated about their selection for the events by 22nd January 2011.
Accommodation Update:
Participants who wish to avail the accomodation facility are requested mail us at peo@gmail.com
The details to be mailed include :
- Number of students
- Date of arrival
- Duration of stay
Note:
1. A decent hotel with all basic amenities will be made available for accommodation.
2. As your college is also invited for Rx Cultaral Festival you may extend your stay for the same which is on 29th and 30th January.
3. You will be informed of the charges of accomodation by 20 th January 2011.
REGISTRATION FORM:
Please copy the registration form given below in a word file and get a print out.
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INDIAN PHARMACEUTICAL ASSOCIATION STUDENTS’ FORUM
MAHARASHTRA STATE BRANCH
RX TECHNICAL SYMPOSIUM
JANUARY 28th 2011.
Venue: Bombay College of Pharmacy, Kalina, Santacruz (E), Mumbai 400098 .
REGISTRATION FORM
Name Mr. / Ms. ________________________________________________________________________
Course & Year of Studying:_________________________ Date of Birth:____________
Member of IPA(Y/N)_________other_________________________________________
University/College/Institution Name and complete address:________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Residential Address: ______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
City:______________ Postal Zip Code:_______________
Mobile:__________________ Telephone: (_______)_____________
Area Code
Email: ___________________________
Events wish to participate (please tick appropriate boxes)
Technical paper presentation
Technical poster presentation
Business Plan Presentation
Pharma quiz
Model Making
Payment Method:
Registration fees:
Rs 100 for one single event(upto 2 events)
Rs 300 for more than two events
Please remit payment by Demand draft payable to “Indian Pharmaceutical Association – Maharashtra State Branch” payable at “Mumbai”
D.D. Number:
Dated:______________________
Drawn on: (Name of the Bank and address)____________________________________ _______________________________________________________________________
_______________________________________________________________________
Rules:
- Every individual participant must send the completed application form to the below address.
- Registration fees includes only the registration cost for the Technical Event and excludes accommodation and other costs.
- Spot registrations are not accepted.
- Registrations are not accepted after 18th January 2011.
- In case of rejection of abstract or cancellation registration fees is non refundable.
- IPA-SF-MSB is not responsible for any personal damage or loss or damage to the properties of participants in any case.
Place: Date:
Signature:
- (Signature over here means that the student has accepted the terms and conditions mentioned on this form)
Please mail completed registration form to:
(courier, speed post, postal mail, etc)
Kind Attn- Mr. Mathew
IPA Office,
Bombay College of Pharmacy,
Kalina, Santacruz (E),
Mumbai 400098.
Phone: 022- 26671072
Fax: 022-26670744
For registration queries: peo.msb@gmail.com
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ACCOMMODATION REQUEST FORM:
Please copy the accommodation form given below in a word file and get a print of the same.
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INDIAN PHARMACEUTICAL ASSOCIATION STUDENTS’ FORUM
MAHARASHTRA STATE BRANCH
RX TECHNICAL SYMPOSIUM
JANUARY 28th 2011
Venue: Bombay College of Pharmacy, Kalina, Santacruz (E), Mumbai 400098
ACCOMODATION REQUEST FORM
Name Mr. / Ms. ______________________________________________________________________
Course & Year of Studying: _________________________ Date of Birth:___________
Member of IPA(Y/N) ________any other______________________________________
University/College/Institution and complete address: _____________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Residential Address: ______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
City: _________________ Postal Zip Code: _________________
Mobile: ________________________ Telephone: (_______) _____________
Area Code
Email: ___________________________
Travel Details:
Date and Time of Arrival:
Date and Time of Departure:
Mode of travel:
No. of days you desire to stay (Not more than five):
Rules:
- Every individual participant must send the completed application form to the below address.
- Fees of accommodation should be paid to the accommodation in-charge by cash after your arrival and it would be distributed on first come first serve basis.
- Accommodation fees includes only the accommodation cost for the Event and excludes food.
- Accommodation request form will be accepted only if sent with Registration form.
- Accommodation request forms are not accepted after January 2010
- Fees of accommodation once paid will not be refundable under any circumstances.
- IPA-SF-MSB is not responsible for any personal damage or loss or damage to the properties of participants in any case.
- Accommodation charges will be posted on the blog on or before 20th January 2011
Place: Date:
Signature:
- (Signature over here means that the student has accepted the terms and conditions mentioned on this form)
Please mail completed form to:
(courier, speed post, postal mail, etc)
Kind Attn- Mr. Mathew
IPA Office,
Bombay College of Pharmacy,
Kalina, Santacruz (E),
Mumbai 400098.
Phone: 022- 26671072
Fax: 022-26670744
For any queries: peo.msb@gmail.com
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