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Movement Disorders Society of India
Leading the Journey Towards Better Mobility, Knowledge and Support for All Impacted by Movement Disorders
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Endorsement for Scientific Programs Application Form
(All fields marked with * are required)
Name of the Scientific Program (Conference/ CME/
Workshop/ Symposium/ Teaching Course/ etc.)
*
Date
*
Venue
*
Objectives of the meeting
*
Mobile Number
*
Degree Course for which thesis has been/ is being submitted
*
Select
DM Neurology
DNB Neurology
Equivalent degree from recognized institution of India
DM (Neurology) or DNB (Neurology) or Equivalent degree
Other
Target audience/ delegates
*
Expected number of delegates
*
Details of Registration charges for the Delegates
*
Number of Faculty(National / International / Both)*
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Source(s) of Funding:
*
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Is the Scientific Program offering CME credit points from Medical Council?
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Is the proposed Scientific Program seeking/ offered
endorsement by any other Scientific Organization/ Society?*
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Upload Scientific Program File
(Only JPG, JPEG, PNG & PDF file allowed, up to 2 MB only)
*
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Upload Brochure File
(Only JPG, JPEG, PNG & PDF file allowed, up to 2 MB only)
*
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I, confirm that the above information is true and I, on behalf of the Organizing Committee, agree with the following terms and conditions of MDSI for endorsement of the Program by MDSI: i. A Scientific Report on the program and a short summary of the income and expenditure for conducting the program will be sent to the MDSI within 3 months following the Program. ii. A generous donation from the balance money after the Program will be made to the Corpus Fund of MDSI, within 3 months following the Program.
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