Student Registration and Abstract Submission form

Student Registration and Abstract Submission form

Basic and Applied Aspects of Health Management Using Radiation, Antioxidants and Nutraceuticals, One-day school on ″Radiation and Redox Process in Health″ & Fifteenth Annual Meetingof the Society for Free Radical Research –India (SFRR-INDIA-17), JANUARY 9-12, 2017, Mumbai, INDIA
Name *

Prefix First Name Last Name
Gender *
Professional Qualification *
Name of Institute/ University/ College *

Institute address *

Residence address

Personal contact number

Area Code Phone Number
E-mail *
Mobile No. *
SFRR-India Member *
Type of SFRR-India Membership
Accomodation required *
Any accompanying Person
Willing to Join One-day School *
Payment details: Name of Bank/ draft No, and date
Payment Amount
Payment includes
Willing to apply for Awards
Age limit < 35y as on 09/01/2017
Title of Abstract
Name of the Authors
Abstract
Upload Abstract
Upload Letter from Research Guide
* Required only if you are applying for Travel award, Best poster award and Best thesis award.
Upload CV
* Required only if you are interested in Oral presentation. Final decision for the Oral presentation will be made by the SFRR-INDIA-17 executive Committee.
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Date *

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