Online registration form for the 'Birth India Conference - Jan. 2012' | Bangalore Birth Network

Online registration form for the 'Birth India Conference - Jan. 2012'

Birth India Conference - Safe and Supported Birth: A Human Right
21st January 2012- Bangalore

Name: *

Designation:

Organization / Affiliation:

Phone / Mobile number: *

email address: *

Resident of City / State: *

Number of persons: *

Accommodation Required?: *

Yes

No

Accommodation required from:

Accommodation required till:

Meal Preference: *

Vegetarian

Non vegetarian

Meals not required

Please Note:

The Registration fee for the conference is payable at the venue. This fee includes a vegetarian lunch and tea/coffee. The fees is ~~Rs. 600~~ ... Rs. 500 if you register before Jan 1st !!!
Registration inquiries can be directed to biconfreg@gmail.com or Ms. Divya Deswal at +91-98117-18141