Online Registration Form (National)

  • Last Name
  • First Name
  • Mailing Address
  • City
  • Pincode
  • State
  • Country
  • Email

Tel (with area code):

  • Residence
  • Office
  • Mobile
  • Fax

Accompanying Person Name:

  • Name 1:
  • Name 2:
  • Preferred Roommate:
Registration Category: MEMBER NON MEMBER ACCOMPANYING PERSON PG & RESIDENTS ALLIED MEMBERS
Additional Registration Package: DELEGATE ON TWIN SHARING DELEGATE + 1 ACCOMPANYING PERSON DELEGATE ON SINGLE OCCUPANCY BASIS
Training Programs: ILEAL INTERPOSITIN MINI GASTRIC BYPASS GASTRIC BYPASS SLEEVE GASTRECTOMY ALLIED HEALTH REVISIONAL BARIATRIC SURGERY