FACULTY ENRICHMENT PROGRAM

organized by IAPCHE in association with SCMI

Dates: 4-8 November 2009

Venue: Bethel, MSMHC Prayer Center, Barapani, Shillong, Meghalaya

Requested deadline for submission: 30 September 2009

Before you register

Eligibility for selection: Teachers from IAPCHE member colleges, individual members of IAPCHE who have put in less than 15 years of service or less than 45 years of age and SCM staff advisers are welcome to participate.

Click here to enroll as an individual member

Note *indicates required field

*Name:         *Title:  

*Age & Date of Birth:         *Sex:  Male  /  Female

Designation:           *Teaching Experience:

                                                       Rank                                                                                   Number of Years

*Institution where you teach currently:  

*Nationality:  

                                         Country

*Passport Number (for foreign delegates only):  

*Place of issue:                        

            *Date of issue:      

            *Date of expiry:   

*IAPCHE Membership Status:     Individual Member   / Institutional Member

Please provide one postal address (at a minimum)

*Preferred mode of communication: e-mail / Institutional Address / Residential Address

Institutional Address:

 Fax:                  Telephone:   

 E-mail:              Skype name:

Residential Address:

 Fax:                  Telephone: 

 E-mail:            Skype name:

Registration fees:

India: INR 1,500/$32 USD (send draft to Dr. J. Dinakarlal)

Developing Countries: US$150
Developed Countries: US$300

*Mode of payment:     Online (credit card)    /      Draft         

            If draft:  Bank        No.        Date

            Send drafts drawn in favor of J. Dinakarlal drawn on Nagercoil to:

            5, Holy Cross Nagar

Nagercoil- 629 004

India

Clicking on submit will send the above information to the program organizers. Please review carefully before submitting.