Venue: Grand Hyatt Mumbai HOW TO REGISTER: 1. Email the completed registration form with credit card information to [email protected] , subject line BIO India Registration. OR 2. Fax the completed registration form with funds transfer information to +91 8860632848, Attn: BIO India Registration. OR 3. Mail the complete registration form with a cheque (payable to BIO) to: Violet Event Mktg. (India) Pvt. Ltd. BIO India International Conference – Flat#G2, Hemadurga Kuteer Apartments, Sai Nagar, Near Hafeezpet MMTS Station, Old Hafeezpet, Miyapur, Hyderabad-500050, India OR 4. Courier the completed registration form with payment to: Violet Event Mktg. (India) Pvt. Ltd. BIO India International Conference – Flat#G2, Hemadurga Kuteer Apartments, Sai Nagar, Near Hafeezpet MMTS Station, Old Hafeezpet, Miyapur, Hyderabad-500050, India CONTACT INFORMATION: Title First Name Last Name □Mr. □Ms. □Dr. □Prof. Telephone (Country Code/Area Code/#) Fax (Country Code/Area Code/#) Delegate E-Mail* Organization / Company Assistant E-Mail Designation/Job Title Mailing Address Street: _______________________________________________________________________________________________________________________ City: _______________________________________________________________________________________________________________________ State/Province : ________________________________________________________________________________________________________________ Zip/Postal Code : ______________________________________________________________________________________________________________ *E-mail and fax number required in order to receive confirmation. Page 1 of 3 . REGISTRATION FEE: *Please check the appropriate boxes. Are you an ABLE Member? □Yes □No Early Rates Advance Rates Category (Before August 22, 2012) (After August 22, 2012 Total or On-site) ABLE Member Individual Delegate □ Rs.10,000 □ Rs. 15,000 Non-Member Individual Delegate □ Rs. 15,000 □ Rs. 20,000 Receipt will be issued and emailed to all registered attendees when payment is confirmed Grand Total Rs. Registration fees include access to all sessions, partnering meetings, breakfasts, luncheons, receptions and presentations. PAYMENT INFORMATION: *Please check the appropriate boxes. All payments must be made in Indian Rupees. □ Funds Transfer: The funds transfer fee will be charged to the attendee and will not be deducted from the registration fee. The additional bank charge is the responsibility of the attendee. BIO India staff reserves the right to charge the additional fee to cover the transfer cost if the fee is not included in the amount paid. The transfer charge is Rs. 170. Please add Rs. 170 to your registration fee total in order for your registration to be accepted. I (We) have wired the grand total on (date) under the name of (name of remitter) through (bank). Name of Bank: Citibank N.A., Hyderabad Account Name: Biotechnology Industry Organization Account Number: 0344528004 Code: CITI000006 Bank Address: CITIBANK N.A., Queens Plaza, S.P.Road, Secunderabad - 500003, INDIA IFSC □ Cheque Payment: Enclosed is a cheque made payable to Biotechnology Industry Organization (Please reference the registrant’s name on the cheque stub) Mail completed registration form with cheque payment to: Violet Event Mktg. (India) Pvt. Ltd.), Flat#G2, Hemadurga Kuteer Apartments, Sai Nagar, Near Hafeezpet MMTS Station, Old Hafeezpet, Miyapur, Hyderabad-500050, India *The processing of your registration will be completed only when we are notified that your registration fee has been received. CUSTOMER SERVICE: CONTACT: Violet Event Mktg. (India) Pvt. Ltd., Conference Department PHONE: +91 40 20041262 FAX: +91 8860632848 EMAIL: [email protected] or [email protected] Page 2 of 3 REGISTRATION POLICY: Cancellation: Cancellation requests must be submitted in writing on or before August 22, 2012, (5:00 pm India Standard Time) to receive a refund. A 3,000 Rs. administrative fee (per registrant) will be deducted from all cancellation refunds. Approved refunds will be processed after the conference. Cancellation requests received after August 22, 2012 will NOT be honored. Email cancellation requests to [email protected]. Registration fees are not transferable to any other conference. Substitution: You may transfer your registration to another individual no later than August 28, 2012 by sending your request to: [email protected]. Registration fee includes access to all sessions, partnering meetings, breakfast, luncheons, receptions and presentations. All attendees must be register and wearing their name badge onsite to participate in conference activities. Registration may not be shared. A government-issued photo ID (driver’s license or passport) is required at check-in. Badges will not be issued without proper identification. Important Registration Deadlines: August 22, 2012 – Early-Bird Registration and Refunds (less administrative fee) September 10, 2012 – Online Registration Closes and Substitution Request INDIA REGION REGISTRATION INQUIRIES GENERAL CONFERENCE INQUIRIES Violet Event Mktg. (India) Pvt. Ltd. Business Development Registrar Conference Department Biotechnology Industry Organization (BIO) Email: [email protected] or 1201 Maryland Avenue, SW [email protected] Washington, DC 20024 USA Telephone: +91 40 20041262 Phone: +1-202-962-6666 Fax: +91 8860632848 Fax: +1-202-488-6306 Flat#G2, Hemadurga Kuteer Apartments, Sai Nagar, Email: [email protected] Near Hafeezpet MMTS Station, Old Hafeezpet, Miyapur, Website: www. bioindia.bio.org Hyderabad-500050, India Page 3 of 3 .