Sri Lankan delegate registration

For Sri Lankan Delegates Only

Make sure to pay the registration fee to the bank first (with your name as reference).
Then upload the bank deposit/ transfer slip with this form to confirm your registration.

Bank Account Details

Account No.
7302-6732
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Account Name
Sri Lanka College of Dermatologists
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Bank & Branch
Bank of Ceylon, Regent Street, Colombo 10

Registration Form

1. Title*

2. Surname*

3. First Name*

4. Email*

5. Mobile Phone*

6. Job Title*

7. Work-place Address (including City)*

8. I would like to participate to the Sri Lankan Night.

YES

9. I will accompany my spouce to the Sri Lankan Night

YES

10. Number of Accompanied Children (Above 12 Years old)

11. Number of Accompanied Children (12 Years old or below)

12. Food Preference (if any)

13. Registration Category*

14. Upload your bank deposit slip/ bank transfer slip as Image/ PDF File* (You must fill this field, or else you will not be able to submit this form)

Welcome to the offcial website of the 12th South Asian Regional Conference of Dermatology

For Sri Lankan Delegates Only

Make sure to pay the registration fee to the bank first (with your name as reference).
Then upload the bank deposit/ transfer slip with this form to confirm your registration.

Registration Categories & Fees

Bank Account Details

Registration Form

Contact Info

Address:

Email:

Phone:

Fax:

About

The Conference

Welcome to the offcial website of the 12th South Asian Regional Conference of Dermatology

For Sri Lankan Delegates Only

Make sure to pay the registration fee to the bank first (with your name as reference).Then upload the bank deposit/ transfer slip with this form to confirm your registration.

Registration Categories & Fees

Bank Account Details

Registration Form

Follow us

Address:

Email:

Phone:

Fax:

Make sure to pay the registration fee to the bank first (with your name as reference).
Then upload the bank deposit/ transfer slip with this form to confirm your registration.