Ayush Society | Workshop Registration

Please fill this registration form only after you have made the payment for the Workshop Program. Thank you in Advance.

* Required field

Name *

Father's Name *

Email *

Address *

Phone No *

Gender *

Category *

Whether PWD ( if yes, type of disability)

Institutional Affiliation (If any) *

Professional Status (Designation) If any *

Rehabilitation Qualification ( If any) *

Area of Specialization *

Ayush Society

Bank Name: State Bank of India (SBI)

Account No: 30354729403

IFSC Code: SBIN0018175

Branch: I P Estate General Branch M-Block, Vikash Bhawan, New Delhi

Registration Fees(Upto 12/01/2020) *

Mode of Payment *

TRANSFER ID NO./NEFT NO./UPI NO./DD NO. *

BANK NAME *