NATIONAL CONFERENCE ON PHARMACOVIGILANCE, PHARMACOECONOMICS

AND OUTCOMES RESEARCH

17TH ANNUAL CONFERENCE OF THE SOCIETY OF PHARMACOVIGILANCE INDIA

7TH INTERNATIONAL CONFERENCE OF ISPOR INDIA

ON
– OCTOBER, 2018, 8TH 10TH
AT
DELHI INSTITUTE OF PHARMACEUTICAL SCIENCES AND RESEARCH, INDIA

REGISTRATION FORM

Name : ___________________________________________________________________________________

Gender: Male/Female Mobile No: ____________________________________________________________

Email (Mandatory): _________________________________________________________________________

Highest Qualification: _______________________________________________________________________

Organization: ______________________________________________________________________________

Address for correspondence: ________________________________________________________________

__________________________________________________________________________________________

REGISTRATION FEE DETAILS

Delegate Fee For Conference Before 20th August, 2018 After 20th August, 2018
Industry ₹ 2500 ₹ 3000
Academics ₹ 1500 ₹ 2000
Students* ₹ 1000 ₹ 1500
International Delegates USD 50 USD 70
Delegate Fee For Pre-conference Before 20th August, 2018 After 20th August, 2018
Workshop**
Industry ₹ 1000 ₹ 1500
Academics ₹ 800 ₹ 1000
Students* ₹ 500 ₹ 700
International Delegates USD40 USD50
*Student delegates should attach a letter from their institute stating their status or copy of student identity card. **Limited seats on first – cum –
first serve basis.

Mode of Payment: The registration fees shall be paid through Bank Draft/Online payment in favor of “Director DIPSAR
CONF 2018”payable at New Delhi.

Details for the NEFT payment

Name of Bank IDBI Branch Name Saket
Account Name: Director DIPSAR CONF2018 Account No. 0110104000369589 IFSC code: IBKL0000110