Foreign Delegates-Please read this page fully before filling up forms.

FOREIGN REGISTRATION FORM  JANUARY 2006
MEDICINA ALTERNATIVA MUMBAI WORLD CONGRESS

I wish to register for the MEDICINA ALTERNATIVA MUMBAI WORLD CONGRESS

NAME: .............................................................................................................................................................................

ADDRESS :.......................................................................................................................................................................

FAX/TEL :.................................................................................. 
E-MAIL :...................................................................................................

I wish to present paper / video / slides for ....................... minutes / workshop of one / one and half /two hours, on TOPIC TITLE :

I WISH TO HAVE MY BIODATA & PAPER HIGHLIGHTS  INCLUDED IN THE WORLD CONGRESS SOUVENIR BROCHURE
One page synopsis of my paper is sent by email; 500 copies I am sending by post / courier to reach Bombay office before 30th November.

Enclosed with letter sent by registered air mail is Travellers cheques  / Bank Draft in favour of <SHAH BEHRAM BAUG SOCIETY >(for US $............................

Or – I will pay the fees amount in cash before 20th January 2006, In Mumbai

Date:                                                                                                                         Signature:

I ALSO WISH TO HAVE ADDITIONALLY TABLE SPACE /BANNER/PRESENTATION TIME
 FOR $ 600/- Bank Draft / of $600/- enclosed.

 WORLD CONGRESS BROCHURE SOUVENIR ADVERTISEMENT SPACE AVAILABLE
If you wish your important bio data and photograph to be included in the WORLD CONGRESS SOUVENIR BROCHURE, please print on fulscap paper size 13.5 x 8.5 inches,

on one side of the paper , your biodata and photo ;

on the other side of the paper main highlights of your research work /presentation ;

make 500 offset xerox copies and send the package by courier to CONGRESS OFFICE ADDRESS , together with Travellers Cheques  /Bank Draft of US $ 100 /- ( Hundred Dollars only.) in favour of SHAH BEHRAM BAUG SOCIETY


NOTE:FOR ALL INDIA Rs. Registration Fees THERE IS A SEPARATE FORM. enquire on mazocolhc@yahoo.co.in, medzcong@rediffmail.com  see page MHC-7 below

PAYMENTS : CASH OR BANK DRAFTS ON ANY BOMBAY BANK IN FAVOUR OF
 SHAH BEHRAM BAUG SOCIETY

With covering letter that the amount
for MEDICINA ALTERNATIVA/S.B.B.S. CONFERENCE A.C.

should be sent to the office address

Mustafa Building, 2nd Floor, Sir Pherozeshah Mehta Road,

Fort, Mumbai – 400 001, India,

 To reach Mumbai office before 30th November  by registered, airmail or courier. 

 __________________________________________________________________________________________

FOREIGN DELEGATES REGISTRATION FORM

Please print this out and post it with your covering letter and registration fees.

__________________________________________________________________________________________

 

Please send Bank Draft payable on any Mumbai Bank or Travellers Cheque in favour of

SHAH BEHRAM BAUG SOCIETY together with this registration form to the above office address:

 

………………………………………..

 

I wish to register and present a
Speech / paper / slide show / video / demonstration

For            minutes / workshop for           hours.


Topic Title /


Equipment required – please indicate:

 

My Name: …………………………………………………………..

Postal Address: ………………………………………………………

………………………………………………………………………….

………………………………………………………………………….

City Pin Code / Country………………………………………………

Tel. No:………………………………………………………………

Fax. No:……………………………………………………………………

E-mail :…………………………………………………………………


My Registration category is – INDIVIDUAL / GROUP

(If Group Delegation Head please write names of four other persons in your group in your covering letter)


REGISTRATION FEES INCLUDE

Veg. Lunch / Morning / Afternoon Tea, Daily Program, Congress Participation Certificate.

Canteen services also available throughout.

Congress Brochure 2 free copies are given to Bio-Data Listed Persons Only. Others get 1 Copy of the Brochure in the Congress Kit.

REGISTRATION FEES –

INDIVIDUAL – US$ 100/- PER DAY – US$ 300/- - FOR 3 DAYS – 21-22-23 JANUARY 2006

PRE-CONGRESS: 20TH JANUARY 2006-ADMISSION FREE FOR REGISTERED PARTICIPANTS

GROUP – FIVE PERSONS – US$ 1200/ - FOR 3 DAYS OR $800/- FOR 21-22 JAN 06 ONLY (DOES NOT INCLUDE ACCOMMODATION)

VICE PATRON – US$ 1000/- FOR 1+3 PERSONS – BENEFIT –4 PERSONS ATTEND – VP IS INVITED TO CHAIR THE CONGRESS SESSIONS + SPECIAL AWARD CERTIFICATE

PATRON – US$ 2500/- FOR 1+7 PERSONS – BENEFIT – 8 PERSONS ATTEND – PATRON IS INVITED TO CHAIR CONGRESS SESSIONS + SPECIAL AWARD CERTIFICATE & MEDAL

 

2006 JANUARY MUMBAI INDIA WORLD CONGRESS
SPECIAL DISCOUNT FOR EARLY REGISTRATION BEFORE 
30th November each year

Registration  Fees :                                                                                                                             Early Registration Discount

A. . ORDINARY DELEGATE                    US $ 100/- per day                                                                                      

 

 

 

     GROUP DELEGATION :                       5  persons  -US $ 1200 for five persons group for 3 days

                                                                         Group delegation head is free and receives award.

                                                    

            PATRON/VICE PATRON:             SEE ABOVE                                                             

  SPOUSE, FAMILY MEMBERS, ACCOMPANYING PERSONS- CONGRESS FEES ONLY             US $ 150 for 3 days

NOTE: Please take a print out of this page. After filling up the form, send it by courier or registered airmail with Bank Drafts and your paper Highlights/bio-data to the Bombay , India, Office address indicated.

 

EXHIBITION TABLE SPACE AVAILABLE – US$ 600/-

(In the Exhibition area outside the building open to public)

BENEFITS: Two persons can attend Congress FREE, plus twenty minutes free speech time within the Congress Program; PLUS SALE OF EXHIBITED PRODUCTS: (One Table – Two Chairs will be provided)

 

ADVERTISEMENT IN THE 2006 WORLD CONGRESS BROCHURE:

Full Page : 13.25 x 8.5 inches – US$ 100/ -

Half Page : 6.75  x 8.5 inches  - US$ 65/ -

ADVERTISE YOUR PRODUCTS WORLD WIDE

 

BIO DATA LISTING IN THE 2006 WORLD CONGRSS BROCHURE; US$ 100/ - PER ENTRY.

This is your chance to reach out to the WORLD. To make yourself and your work well known WORLD WIDE. Please send your: One page Bio-Data, Passport size black and white photograph and highlights of your work printed on paper size 13.5 x 8.5 inches computer laser print both sides of the sheet.

Before 30th November 2005. Late entries not accepted.


FREE 2 BROCHURE COPIES GIVEN TO ALL PERSONS WITH BIO-DATA LISTINGS.

VISA FOR INDIA

 

YOU ARE ADVISED TO APPLY FOR TOURIST VISA FOR ONE MONTH FROM THE INDIAN EMBASSY IN YOUR COUNTRY DURING NOVEMBER/ EARLY DECEMBER 2005. VISA MUST BE OTAINED BEFORE BOARDING FLIGHTS. NO VISA AVALIABLE ON ARRIVAL AT INDIAN AIR PORTS. EARLY RESERVATION OF AIR TICKETS AND HOTEL BOOKINGS RECOMMENDED BEFORE 30TH NOVEMBER 2005 –BOMBAY HOTELS LIST AVAILABLE BY REQUEST – EMAIL: medzcong@rediffmail.com

Continuation page MHC- 6

 


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