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STEP 1 :

Indian

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STEP 2 : Personal Information

Title:*

First Name:*

Middle Name:

Last Name:*

Affiliation:*

Mobile No. :

IADVL Membership No.

Alternate Email Id:

HOD LETTER / COLLEGE ID CARD

Contact Information

Address:*

Country:*

State:*

City:*

Zip/Pin Code:*

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STEP 3: Workshop / Masterclass / Session

Workshop / Masterclass / Session

Yes No

Date	Time	Workshop / Masterclass / Session	Fees
DAY 1
28-07-23	9:00 AM - 11:00 AM	Workshop: Lifting The Face with Threads & Sutures (Demonstration of Bi-Directional Threads; Hands-on for Mono & Cog Threads)(W)	2500
DAY 1
28-07-23	3:00 PM - 5:00 PM	Workshop: Bio-Remodellers & Skin Boosters - Injectables (Demonstration/Hands-on for Hyaluronic Acid Remodelling Injectables and other procedures)(W)	2500
DAY 1
28-07-23	2:00 PM - 4:00 PM	Workshop: De-Wrinkling the Face with Botulinum Toxin A - Upper Face (Demonstration/Hands-On for Botox A for upper face expression lines(W)	2500
DAY 1
28-07-23	4:00 PM - 6:00 PM	Workshop: De-Wrinkling the Face with Botulinum Toxin A - Lower Face (Demonstration/Hands-On for Botox A for Lower Face Indications - DAO/Platysmal Bands/Nefertiti Lift/Masseter/Chin(W)	2500
DAY 2
29-07-23	9:00 AM - 11:00 AM	Workshop: Laser Hair Reduction (Lectures, Demonstration & Hands-On on Different Technologies)(W)	1500
DAY 2
29-07-23	3:00 PM - 5:00 PM	Workshop: Fractional Resurfacing Devices and Technolohies for Scars (Lectures, Demonstration & Hands-On on Different Technologies)(W)	1500
DAY 2
29-07-23	2:00 PM - 4:00 PM	Workshop: Facial Augmentation With Fillers - Mid-Face (Demonstration/Hands-On for Mid-Face indications of Dermal Fillers - Tear Troughs, Cheek Augmentation, Facial Lifting)(W)	2500
DAY 2
29-07-23	4:00 PM - 6:00 PM	Workshop: Facial Augmentation With Fillers - Lower-Face (Demonstration/Hands-On for Lower-Face indications of Dermal Fillers - Chin & Jawline Contouring)(W)	2500
DAY 3
30-07-23	9:11 AM - 11:00 AM	Workshop: Pigment Reduction Lasesrs (Lectures, Demonstration & Hands-On on Different Technologies)(W)	1500
DAY 3
30-07-23	3:00 PM - 5:00 PM	Workshop: Skin Tightening - HIFU, Radio-Frequency etc. (Lectures, Demonstration & Hands-On on Different Technologies for Non-Invasive Skin Tightening and Contouring)(W)	1500
DAY 3
30-07-23	2:00 PM - 4:00 PM	Workshop: Everlasting Eyebrows - (Microblading) (Lecture, Demonstration & Hands-on for Eyebrow Micropigmentation Treatments)(W)	3000
DAY 3
30-07-23	4:00 PM - 6:00 PM	Masterclass: Non Cultured Epidermal Suspension (NCES) in Vitiligo (Lecture, video demonstration, step-wise details of NCES)	1500
DAY 28-30 July 2023 ( Friday to Sunday )
"Kindly note the timings/dates of workshops and masterclasses carefully to avoid any clash. Once registered, no refund, transfer or exchange will be possible."

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Details of Payment

PARTICULARS	AMOUNT
Additional Workshop
Registration Fee
Cost of Accompanying Person(s)
Additional Workshop Fee
Banquet Cost
CGST (9%)
SGST (9%)
TOTAL COST
3.5% Bank Charges (In case of payment by credit/debit card)
GRAND TOTAL

Mode of payment

Total Amount Payable:

Mode of payment

Beneficiary Name	M/S THE SKIN AND AESTHETICS ACADEMY
Account Number	91111010002994 (14 Digit A/C No)
Bank Name	Canara Bank
Branch Name	Ganga Ram Hospital, Rajinder Nagar, New Delhi
PAN No.	AAMFT8452D
RTGS/NEFT (IFSC) Code of the Bank	CNRB0019111

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STEP 2 : Personal Information

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STEP 3: Workshop / Masterclass / Session

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