Resident Registration for the Jaipur Congress
The Dandy Society is Sponsoring a Number of International Residents to Cover the Registration Fee Plus 3 Nights Stay at the Clarion In Jaipur- Luxury hotel in Jaipur | 5-star hotel in India. Please fill out this form and submit to be considered for this Scholarship The Scholarship Committee will make the selections. If you are accepted you will be notified so that you can start making your travel plans.* Please Note: For Residents based in Indian Programs, your Registration is being conducted by the Dandy India Chapter. Please contact the India Chapter: profpande@yahoo.com, Contact person Ms Souparnika, Ms Sandhya
First Name
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Last Name
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Name of Institution/hospital
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Year of Residency
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City
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Country
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Email Address
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Phone number (including country code)
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