WhatsApp Image 2025-03-07 at 10.38.54_81d4f598WhatsApp Image 2025-03-07 at 10.38.54_81d4f598 Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *Designation & Department *Organisation Name *Organisation Address *City *State/Province *ZIP / Postal Code *Country *Email *Mobile *WhatsApp Mobile *Address For Correspondence *City *State/Province *ZIP / Postal Code *Country *Select Packages Type *Select Packages TypeNon-Residential PackageResidential PackageSelect Non-Residential Packages *Select Packages Accompanying Person Spouse/ Family MemberConference + Human Cadaver WorkshopConference RegistrationESFI/ WESS/ SSO/ BSS Members Conference + Human Cadaver WorkshopESFI/ WESS/ SSO/ BSS Members Conference RegistrationPG Students/ FellowsPG Students/ Fellows Conference + Human Cadaver Workshop1st Feb to 31st Mar 2025 INR 8850.00 USD 102.00 1st Feb to 31st Mar 2025 INR 36225.00 USD 418.00 1st Feb to 31st Mar 2025 INR 19470.00 USD 224.00 1st Feb to 31st Mar 2025 INR 34810.00 USD 401.00 1st Feb to 31st Mar 2025 INR 17110.00 USD 197.00 1st Feb to 31st Mar 2025 INR 10620.00 USD 122.00 1st Feb to 31st Mar 2025 INR 28320.00 USD 327.00 Select Residential Packages *Select Residential Packages 2 Nights 3 Days3 Nights 4 DaysSelect 2 Nights 3 Days Packages *Select 2 Nights 3 Days Packages Double Occupancy at Mayfair ConventionDouble Occupancy at Mayfair LagoonSharing Room at Mayfair ConventionSharing Room at Mayfair LagoonSingle Occupancy at Mayfair ConventionSingle Occupancy at Mayfair Lagoon1st Mar to 30th April 2025 INR 60180.00 USD 710.00 1st Mar to 30th April 2025 INR 71980.00 USD 850.00 1st Mar to 30th April 2025 INR 33040.00 USD 390.00 1st Mar to 30th April 2025 INR 47200.00 USD 560.00 1st Mar to 30th April 2025 INR 40120.00 USD 480.00 1st Mar to 30th April 2025 INR 59000.00 USD 700.00 Select 3 Nights 4 Days Packages *Select 3 Nights 4 Days PackagesDouble Occupancy at Mayfair ConventionDouble Occupancy at Mayfair LagoonSharing Room at Mayfair ConventionSharing Room at Mayfair LagoonSingle Occupancy at Mayfair ConventionSingle Occupancy at Mayfair Lagoon (Size & 1st Mar to 30th April 2025 INR 68440.00 USD 810.00 1st Mar to 30th April 2025 INR 83780.00 USD 990.00 1st Mar to 30th April 2025 INR 42480.00 USD 510.00 1st Mar to 30th April 2025 INR 56640.00 USD 670.00 1st Mar to 30th April 2025 INR 50740.00 USD 600.00 1st Mar to 30th April 2025 INR 70800.00 USD 840.00 Mode of Payment *Select Mode of PaymentBank To Bank TransferRTGS/NEFTUPIQR CodeBENEFICIARY NAME : ENDOSCOPIC SPINE FOUNDATION A/C NO : 610000000043531 IFSC CODE : SRCB0000426 NAME OF BANK : SARASWAT BANK BRANCH : AMBADI ROAD VASAI (WEST) PAN : AABTE3859N Upload file (Size Max 3 MB) *Upload screenshot of Fees Transaction Details*Submit
