Neurosurgeons Registration to India Congress Neurosurgeon Registration for the Jaipur Congress Title*Dr.Mr.Ms.Prof.First Name* Last Name* Name of Institution/hospital* City* Country* Email Address* Phone number (including country code)* Please check this box if you need us to provide a letter for your Hospital/Institution.*Please note for your Visa application for India you may wish to obtain a Tourist Visa.The Academic/Congress Visa requires substantial more paper work. Yes No Please select the three nights hotel stay*January 19, 20, 21January 20, 21, 22Registration Fee include Plus 1) Congress Registration 2) Three Nights Stay at the The 5-Star Vijayran Royal Quest Hotel Palace or the Jaibagh Palace3) Meals (breakfast, lunch, and dinner)4) Admission to the Hands-On Microanastomosis Course(the number of seats are limited for the course, so it is based on first come first serve basis)I would Like register for the Micro-anastomosis/EC-IC Bypass Course*YesNo* Please Note: There are limited number of spots for the course. It will be first come first serve. We will do everything to accommodate, but cannot guarantee.Total Fee: $0.00 Credit CardCard Details Cardholder Name CAPTCHA Δ
