Registration

REGISTRATION FORM FOR OCCUCON 2024

If delegate will registered by online by link and not pay by the sme mode of the link provide than registration will not be confirm and the payment done by other offline mode will be not accepted and not return back

Registration being done by*

Individual

Organization

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NOTE: If you have a mix of IAOH members and IAOH non-member participants, please choose the offline mode for payment for which contact the IAOH-Vadodara office staff (Ms. Jinal Shah - 9978908780)

Name of Organization*

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Number of Participant*

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Enter name of Persons*

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Name*

Please let us know your name.

Gender*

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Age*

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Address*

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City*

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State*

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Country*

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Your Email*

Please let us know your email address.

Mobile*

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Do you have GST number?*

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Name as per GST Certificate*

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GST No*

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Confirm GST No*

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Delegate Type*

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Registration Fees*

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Registration Fees*

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Registration Fees*

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Registration Fees*

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Registration Fees*

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Note: Discount will be applied at the time of payment.

Membership No

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Do you require support for accommodation?

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Payment Option*

Pay Online

Pay Offline

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Payment Details:

You can do payment through DD/Local Cheque/Multicity Cheque drawn in favor of "INDIAN ASSOCIATION OF OCCUPATIONAL HEALTH VADODARA OCCUCON 2024" payable at Vadodara. Outstation cheque will not be accepted. Payment can also be done through Gpay or Phonepe by entering account no. and IFSC code given below.

Bank Account Details for payment of Registration fees for OCCUCON 2024

Bank Name: AXIS Bank LTD
A/C Name: INDIAN ASSOCIATION OF OCCUPATIONAL HEALTH VADODARA OCCUCON 2024
A/C No: 923020021526318
IFSC: UTIB0000383
Branch: Nizampura, Vadodara - 390002

Kindly upload Screenshot of Payment made

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Payment Reference ID*

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Enter Captcha*

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NOTE: GST Rate and Payment Gateway charges are to be added at the payment time