17th Phonosurgery Course and International Workshop (Hybrid) Registration

Scientific Programe

28th October 2023:- LIVE SURGERY DEMO & LECTURES - VIRTUAL (Zoom)

29th October 2023:- Hands on Thyroplasty, Injection Laryngoplasty and Office based laryngeal procedures- PHYSICAL at Century Hospital, Road No 12, Banjarahills, Hyderabad

Please fill the below form to attend Workshop On 28th and 29th October 2023.

First Name

Last Name

Willing To Attend

Live Surgery Demo on 28th October on Zoom

APSI Member - Live.Surgery Demo on Zoom

Hands on Thyroplasty & Injection Laryngoplasty

Live Surgery and Hands on

For Hands on Office-based Laryngeal Procedures

SLP on 29th October

APMC Registration No/Local Registration No

Total Amount To Pay:

Gender

Male Female

Address

Mobile Number

Email

Paid Through

To Bank Account

To UPI Id(From Google pay/Phone pay/ etc..)

Amount Paid

Transaction Ref. Number

Payment Date

Upload payment Screen shot/Photo

Registration Fee

Live Surgery Demo on 28th October on Zoom--- Rs 3000/-

APSI Member - Live.Surgery Demo on Zoom---Rs 0/-

Hands on Thyroplasty & Injection Laryngoplasty---Rs 5000/-

Live Surgery and Hands on --Rs 7000/-

For Hands on Office based Laryngeal Procedures Rs 25000/-

SLP on 29th October Rs 2000/-

On-line Application Process :

Step 1:Fill the on-line application, All details are Mandatory

• Name
• Willing to Attend
• Type of payment Amount Paid
• Payment reference
• Transaction details
• Email
• Phone etc...

Step 2: Make the payment through online ( IMPS/NEFT) to below given account OR Pay through UPI by scanning given QR Code after that enter the details like amount paid and transaction details etc.., in the registration form

Step 3:We will verify the details and allocate the registration number to attend conference:

• Though Whatsapp Group

Step 4:You can reach us, if you need any details through:

• Dr.A.Meenakumari
• Course coordinator
• Call: 9849133268 / 9848134018
• Email:drvoicep@hotmail.com
• Send Payment details by Whatsapp to 9849133268 or by Google form