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IMA-H.Q. and all other state IMAs have web sites,e news letters,emagazines.

our andhra pradesh state IMA decided to make an interactive blog to convey & exchange the thoughts of the members.

Monday, June 8, 2009

IMA A.P. STATE STUDY PROGRAM TOUR REG.FORM.

• INDIAN MEDICAL ASSOCIATION -A.P STATE STUDY TOUR to THIALAND (4days) &SRILANKA(1day).

REGISTRATION FORM.

1 NAME: ( in block letters)

2.Mention the names of accompanying persons :


ADDRESS:
4. CONTACT NUMBERS:
Land line:
MOBILE:
EMAIL:
EMERGENCY NUMBERS:
(Numbers to call in case of emergency)
5. PASSPORT NUMBER: ISSUED AT: Validity upto:

6. DEMAND DRAFT NUMBER: FOR: Rs.
ISSUING BANK DATED:
Please note:
1. Take three Photo copies of 1st and last pages of your passport and keep with you and . Keep a photocopy of the D.D.
Enclosures.
1. Original passport
2. Demand draft for Rs.15. 000.(before 30th June2009), &
3. passport size Photos ; 4 no.s

Please fill and send this along with said enclosures to DR.L.V.RAGHAVRAO,
10-2-9/3, SIRIPURAM, VISAKHAPATNAM on or before 30th.june-2009.

Program coordinator: Dr.L.V.RAGHAVRAO

President: Dr.N.Kishore. General Secretary: Dr.Ch.Srinivasa Raju.

PLEASE COPY THIS FORM IN TO WORD FILE AND UTILISE.
THANK Q.
Posted by at

2 comments:

bachani said...

I WANT TO JOIN TOUR IS 30000/ IS FOR THAI AND SRILANKA BOTH HOW I CAN SEND MY PASSPORT IT CAN BE LOST IN TRANSIT

June 14, 2009 at 2:25 PM
Dr. srinivasa raju said...

DEAR DR.BACHANI
THANKS FOR YOUR ENTHUSIASM AND HOPE YOU ENJOY THIS TWO NATION TOUR AT THE COST OF 30000/-PER PERSON.
YOU CAN SEND THE ORIGINAL PASSPORT BY COURIER TO DR.L.V.RAGHAVRAO,WHOSE ADDRESS IS GIVEN IN THE REGISTRATION FORM.
DR.SRINIVASA RAJU

June 28, 2009 at 10:14 PM

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