Greetings from Retina India!

We are happy to inform you that the last date for submitting the
registration forms for retinAware has been extended to 16th September,
Friday 5 pm.
As we have to submit the forms in advance for security reasons, no
forms shall be accepted after the above mentioned time.

Please hurry up with the registrations as we can not accommodate
anyone once the capacity of the hall is filled up.

Read the details:
Retina India is pleased to inform you about the following for its
national convention being organized at the Vigyan Bhavan in New Delhi
on Sep 24 & 25, 2011, and to be inaugurated by Dr APJ Abdul Kalam, in
the presence of host of dignitaries:

1. Free delegate registration for the national convention, retinAware
2011, New Delhi
2. Free medical consultation for registered delegates during the convention

1. Free delegate registration: We have been able to secure a
sponsorship that allows free entry to registered delegates for the
convention. This facility is open to all on a first-come-first-serve
basis. Registrations are compulsory on or before 10th September 2011.
The names of registered delegates have to be sent to the security
agencies for clearance due to the presence of VIPs during the
convention.

Please register by 16th September 2011, since the seats are limited.
Once we reach the allowed number of delegates for Vigyan Bhavan, we
will not be able to accommodate any additional delegates.

For those who have already paid the registration fees, we will be
contacting you separately.

2. Retina India will offer free medical consultation to registered
delegates, where visiting doctors will be available to examine and
review patients. Those desirous of availing of this facility are
requested to carry the case papers from their previous doctor visits.

To register for the convention, you can do the following:


Copy the following form and  paste it into a word document.  You can
fill it up and send to us either as an attachment or through post to
the address given in it.

Beginning of the form:
Retina India

Delegate form (free registration) for retinAwareTM 2011, New Delhi

You can enter your responses in English on your computer and save the
file. Send the file as an attachment to [email protected].
You can also print the form, enter the particulars legibly in English
and in capital letters, and send the completed form in an addressed &
stamped envelope to: Retina India, Ridhi Sidhi Bhavan, 2nd floor 2/12,
Babu Genu Road, Mumbai 400002, India
        
Delegate (Patient, Family member of a patient, Volunteer, etc)
Associate Delegate (Each accompanying person with the above delegate;
maximum two)
Children (above 12 years of age accompanied by an adult)
Note: Children under 12 years of age are not allowed.

Name: (Choose one) Mr / Mrs / Ms
Address:
City:
State:
Pincode:
Phone: (Mobile/Residence/Office)
Email:

Associate Delegate/s:
a. Mr / Mrs / Ms
b. Mr / Mrs / Ms

•       We will acknowledge the receipt of your form preferably by email.
•       Please bring an official Government issued document, which has your
photograph, with you to the venue for security verification.
•       The free registration allows you entry to the venue of the
convention, to the halls that are meant for convention delegates, and
to the exhibit area only.
•       While at the convention, you must follow all the rules as deemed
necessary by the security agencies. Also, please adhere to any
requests by the official volunteers of Retina India.
•       If you have any queries, please write to above email ID for any
clarification. Or call +918976658402 between 1pm and 7pm any day of
the week. Or our helpline at +91 98200 87755 between 10am & 6pm.

By signing the form (or entering your name below in case of an
electronic file), you agree that you (and/or all your representatives)
will not hold the organizers (including but not limited to officials
and volunteers) legally (or otherwise) responsible for any damages or
losses due to an untoward incident, or a change or cancellation of any
part or all of the convention.


(Signature)                             (Name)                                  
(Date)

End of the form.



For any information, you can also:
1. Write to [email protected]
2. Call +91 89766 58402 (Mumbai)
3. Call +91 98200 87755 (Retina India Helpline)
4. Call +91 89399 11897 (Chennai)
Convention Venue: Vigyan Bhavan, Maulana Azad Road, New Delhi – 110049




-- 
G. Vamshi
PH Res : +91 877-2243861
Mobile: +91 9949349497
E-mail ID:
[email protected]
Skype: gvamshi81

www.retinaindia.org
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