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SCRFI, Manipal Institute for Stem Cells & Regenerative Medicine
9th Floor, Manipal Hospital
Airport Road
Bangalore-560 017
India.

"REGISTRATION CLOSED" SCRFI STOPS ACCEPTING FURTHER REGISTRATIONS.

CONFERENCE REGISTRATION FORM

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Fee and Payment Information

Full Conference Registration

Particulars	Before November 30^th, 2006	After 1^st December, 2006
Indian Participants	INR 3500	INR 4500
Post Docs	INR 2500	INR 3500
Accompanying persons	INR 1500	INR 2500
Students	INR 1500	INR 2500
Foreign participants	US $ 250	US $ 350
Accompanying person	US $ 175	US $ 275

Payment must accompany registration and can be made by Demand Draft (DD) Wire Transfer, VISA, or MasterCard. Secured Online payment can be done through internet.

DD should be in favor of “Stem Cell Research Forum of India” payable at Bangalore

Details of DD No.	Amount	Date
Drawn on	Visa or MasterCard no.	Name on Card
Expiry	Signature

Wire Transfer: Please credit the remittance through
ICICI Bank Commissariat street, Bangalore
Beneficiary Name: Stem Cell Research Forum of India
Beneficiary address: 9th Floor, Stem Cell Research Center, Manipal Hospital, Airport Road, Bangalore-560 017, India
Beneficiary Account: 000201071344
Swift Code: CHASUS33XXX
FED ABA: 021000021
Correspondent Bank: J.P Morgan Chase, New York, A/C no. 0011427374.

Mail Your Registration To:
Filled registration form along with the payment should mail to the following address:
Stem Cell Research Forum of India
9th Floor, Stem Cell Research Center, Manipal Hospital
Airport Road, Bangalore-560 017, India Tel: 91-(0)80-2506 4601, 2506 4602, 2506 4603, 2506 4611
Note: Payment through Fax will not be accepted.

On-line Payment: Please click here for payment gateway.