SCS Conference 14 (ISSICON 2014) th

Registration Form
Name: First name:
Institute/Hospital:
Postal Address:
City:
Postal/Zip Code:
Country:
Email id:
Tel. (with area code):
Residence:
Mobile (mandatory):
Fax:
Registration for:
[
] Conference only [
List of hotels for accommodation within 5kms of distance from conference venue
Last name:
Hotel
State/Province:
Contact No. ( code: +91-2692)
Hotel Relax
267473, 242429
3rd floor, Hariba
Vyapar Bhavan, GPO
road, Anand
Motel Sanvaria Regency
235090, 235091
Motelsanvaria2007yahoo.in
2nd floor, ”SHILP”,
Opp. Bhaikaka statue,
Vallabh Vidyanagar
Hotel Surabhi Regency
242018, 242279, 242601, 254054
hotelsurabhiregencyyahoo.co.in
Jay tower, Amul dairy
road, Anand
Hotel Favourite Regency
230884
Nr.Railway Crossing,
Vallabh Vidyanagar
Hotel Pooja Inernational
254253
Amul dairy road,
Anand
Hotel Laksh Residency
267897, 267898
[email protected]
Laksh Prime, Opp town
hall, Anand
Hotel La Casa Inn
264801, 264802
[email protected]
Near Ganesh Crossing,
Anand-Sojitra road,
Anand
Hotel Rama Regency
266446, 266447
3rd floor,Shri Ram
arcade, Old Gopal
Cinema, Anand
Madhubhan Resort
18002339009
[email protected]
Anand Sojitra road,
Anand
Office:
] Conference and workshop [
] Workshop only
Registration Category:
[ ] SCS Member [ ] SCS Non-member [ ] PG Student/Spine Fellow
[ ] Medical Professional [ ] Paramedical Professional**
(**Please encircle one Nurse/Psychologist/Social Worker/Parents/Other)
All future communication through email and SMS
Total amount to be paid for conference:
(In words)
Payment type: [ ] Online transfer • Transfer reference no:
[ ] Demand draft • Name of bank:
• Date of issue:
Demand draft No:
Registration fees for medical professionals:
Categories
Conference only
Conference& workshop
Workshop only
Members
4000
5000
2000
Non members
5000
6000
2000
Fellow/PG student
2000
3000
1500
Registration fees for Physiotherapist and Occupational therapist:
Categories
Conference only
Conference& workshop
Workshop only
Members
2000
3000
1500
Non members
2500
3500
1500
Fellow/PG student
1500
2000
1000
Registration fees for Paramedical professionals, Parents and consumers:
Categories
Conference only
Conference& workshop
Workshop only
Members
1500
2000
1500
Non members
2000
2500
1500
Fellow/PG student
1500
2000
1000
Cancellation statement: Cancellation of participation received at conference office by 1st November 2014
will be accepted and all fees refunded less an administration fees of Rs.500/-. Cancellation received after 1st
November 2014 will not be refunded.
Address
Please send your registration along with DD to:
Dr. R. Harihara Prakash, Organising Chairperson ISSICON 2014
K. M. Patel Institute of Physiotherapy
Shree Krishna Hospital, Karamsad- 388325, Gujarat, India
Email: [email protected] | Phone:+91-2692-228281
Contact: Mr. Bakul Parmar
Phone: +91-9714269886
Email: [email protected]
SEND YOUR ABSTRACTS ON [email protected]
For more details visit www.issicon2014.com
14th SCS Conference
(ISSICON 2014)
November 7 to 9, 2014
K. M. Patel Institute of Physiotherapy
Shree Krishna Hospital, Karamsad, Gujarat.
H M Patel
Centre for
Medical Care
& Education
ACCREDITED FOR: DIAGNOSTIC LABORATORIES • BLOOD BANK IMAGING SERVICES
• HOSPITAL
Pre-conference Workshop: November 7, 2014
Organized by :
K.M. Patel Institute of Physiotherapy, Karamsad.
www.charutarhealth.org
Dear All,
Residence of the Great Visionary Leader, Iron Man of
India - Sardar Vallabhbhai Patel at Karamsad.
(Distance from Conference Venue - 1 km)
Heart of the city, Amul Dairy, Anand
The largest food brand in India and largest Milk brand in
World
(Distance from Conference Venue - 7 km)
Greetings from Karamsad, the land of Iron Man of India, Sardar Vallabhbhai Patel.
K. M. Patel Institute of Physiotherapy, charutar Arogya Mandal, Karamsad takes pride in
its eneavor towards quality with its achivement of being the first physiotherapy college in
the country affileted to a medical college, to be accredited by National Assessment and
Accreditation Council (NAAC) in the year 2013.
It gives us great pleasure in inviting you to ISSICON 2014, which will be combined
meeting of Spinal Cord Society and Asian Spinal Cord Network.
The conference will be preceded by one day workshop on, “ comprehensive Care in SCI”
which will be limited to few participants.
Thus with great pleasure and pride, we at K. M. Patel Institute of Physiotherapy, Karamsad,
invite and welcome you to the milk city of India, Anand, for enriching experience to
International Conference ISSICON 2014.
Famous Pilgrims Center, Grand Temple of shri Ranchod
Raiji, Dakor.
(Distance from Conference Venue - 44 km)
Akshardham Swaminarayan Temple, Gandhinagar.
(Distance from Conference Venue - 102 km)
Organising Chairpersons
Spine surgeons
Orthopedicians
Neuro Physicians
Spinal cord injury
Specialist/rehabilitation
Physicians
Physiotherapists
Occupational therapists
Psycologists
Orthotists
Nurses
Social workers/counselors
Neurologists/ Urologists/Pain
Specialists
Gatsroenterologists/Psychiatrists
Consumer group
Programme Schedule
Day 1 Friday November 7, 2014
9:00am to 5:00pm
Workshop
Day 2 Saturday November 8, 2014
8:30am to 11:00am
Plenary Session
11:00am to 5:00pm
Conference
7:00pm to 9:00pm
Cultural Program and Dinner
Day 3 Sunday November 9, 2014
8:30am to 11:00am
Plenary Session
11:00am to 5:00pm
Conference
Dr. R. Harihara Prakash
Dr. Harvinder Singh Chabbra
Highlights
Laxmi Vilas Palace, Baroda
(Distance from Conference Venue - 55 km)
Participants
Message from Chairperson
Places nereby karamsad
• Pre conference workshop on comprehensive management of SCI
• Spinal Cord Socitey and ASCoN best paper and poster award
• Topics of interest for whole team including doctors, therapists, nurses, Psycologists,
social workers and peer counsellors
• Prominent national and international faculty
Payment details
Option 1: (By Demand Draft)
Demand draft drawn in favour of ‘Charutar Arogya Mandal’ payable at Karamsad.
Option 2: (By Bank Transfer)
Name of Account: Charutar Arogya Mandal
Name of Bank: Bank of Baroda, Karamsad branch
Account No.: 03050400000095 SWIFT Code: BARBINBBAN
IFSC No.:BARB0KARAMS Branch Code: 0305