22nd Congress of PENSA 2022, 25th - 27th November 2022 | HICC Hyderabad, India.

Download Registration Form (PDF)

Member Registration
Full Name *   Dr   Mr   Mrs    Ms 
Institution / Hospital *
Designation *
Permanent Address *
City *
State *
Pin Code *
Phone    
   ISD           STD           Phone no   
Mobile Number *
Email *
Type *
Professional Category * Academic Background: (indicate degrees / diplomas, year from which it was obtained)

Physician (Indicate Specialty)
Dietician / Nutritionist
Pharmacist
Pharmacologist
Nurse
Biochemist
Industry
Others (Specify)
Payment Mode * Online    DD/Cheque    Bank Transfer(NEFT)

 

     * Fields are Mandatory


 
Registration Fee Details..... Kindly note: Online Registration
Physicians Rs.3,000/-
Non-Physicians Rs.1,500/-
Industry Rs.50,000/-
Foreign
Physician US$ 200
Non-Physician US$ 100


* Only at Par Cheques payable at Chennai will be accepted.
* All Cheques/DDs may be made in favour of "ISPEN" payable at Chennai.
* Fee once Paid will not be refunded.
Bank Account Details

Account Holder: ISPEN
Account No.: 497501010036181
IFSC Code: UBIN0541231
Bank: Union Bank of India, Chennai 600006

Please post the Cheque/DD to

PRESIDENT ISPEN 2005 - 2019
Dr Varsha, MSc PhD RD CNIS
Shri Shraddha # 5 Third Street
Dr Thirumurthy Nagar
Nungumbakkam
Chennai 34.

The candidate's name and place should be written on the back of the Cheque/DD



Contact Now

  • "Shri Shraddha ",
    No.5,3rd street,
    Dr. Thirumurthy Nagar, Nungambakkam,
    Chennai-600034.
  • +91 98410 82244
  • ispenindia@gmail.com