Home+ REF+ Radiology in India+ Radiology World Over+ Radiology Links
REF

REF Publications

 
REF Events : CHEST UPDATE 2017- 11th to 12th November 2017

Registration Form :
Online Registration for those who are paying by Credit Card.

First Name:
Last Name:
Age:
Sex:
Address:
City:
State :
Pin Code:
Contact No. (IMP):
E-mail (IMP):
Institution:
Please Choose: Consultant
Resident
Medical Council Registration Number (IMP):
Name of Head of Dept:

Amount Rs:

( Rs 5000, if consultant, Rs 2500, if resident)
Please enter a numeric value in the box e.g. 2500. Please DO NOT enter any text or non-numeric characters in the box. (credit card payment)
  
 

*Credit / Debit Card payment: REF is pleased to announce that we now accept national and international credit / debit cards! The transaction is secure and done through Axis Bank.. As soon as we get intimation about your payment, you will be issued the registration number by email, and this will serve as your receipt.

Please Note:

Payment by Demand Draft:
If payment is not being made by credit card, then please send a demand draft in favor of "Radiology Education Foundation, A/C Conference" for Rs. 5000/-, if consultant and Rs 2500/-, if resident.

PLEASE DO NOT FILL UP THIS ONLINE FORM IF PAYMENT IS BY DEMAND DRAFT OR CASH.

PLEASE PRINT A COPY OF THE FORM AND SEND IT BY COURIER WITH THE PAYMENT ALONG WITH THE SIGNATURE OF THE HEAD OF DEPARTMENT, FOR PURPOSES OF VERIFICATION. THIS HAS TO BE DONE EVEN IF THE PAYMENT IS BY CREDIT / DEBIT CARD.

 


To pay by Cash or Demand Draft please print the form, fill it up with the relevant details and mail it to the address given below. Please write your name on the reverse of the DD. Please fill in the following:
DD No:
Date:
Bank:
Amount :

NEFT Details: .

1. City : Mumbai

2. Bank : Bank of India

3. Branch : Prarthana Samaj

4. Swift code of beneficiary bank: BKIDINBBPRS

5. Beneficiary A/c Type & No.:SAVINGS' A/C,- No.003910100017480

6. Full Name of beneficiary : Radiology Education Foundation A/c Conference

7. The IFSC Code  - BKID0000039.

8. MICR Code no:- 400013048

To pay by NEFT please print the form, fill it up with the relevant details and mail it to the address given below

Please send the printed form along with Cash/DD/NEFT details to the following address:
Radiology Education Foundation,
"F", 1st Flr, Bhaveshwar Vihar,
383 Sardar V P Rd,
Mumbai 400 004.
Tel 022-66173333

Attn: Ms. Shamina

Fax 022-2382-9595

 

 

 

 

 

 

 

+ About REF

+ REF Activities
- REF Events
- REF Publications

+ REF Scholars

+ REF Quiz

+ REF Interactive

+ Contact REF