2027 PCOACON 2.0 Registration Form Click here for brochure Click here for brochure Name *Email Address *MMC Registration No. *Whatsapp No. *GST No.(If applicable)0 / 17Emergency Contact DetailsName *Contact No. *Are you a Delegate or Faculty? *DelegateFacultyAre you a Consultant or PG Student? *ConsultantPG Student(3 Sharing – Budget Friendly)Are you a? *PCOA MemberNon-PCOA MemberAre you willing for Faculty? *ResidentialNon - ResidentialFaculty Non-Residential AmountNon-residential amount with GSTAccomodation Requirement - Residential *SingleDoubleFaculty Residential AmountResidential amount with GSTFaculty coming with *AloneWith FamilyFaculty alone amountFaculty Alone amount with GSTFaculty family members with you?Members above age 18?Members between 12-18yrsMembers between 6-12yrsFaculty accompanying person infoNameAgeRelationRelationSpouseDaughterSonFriendFaculty with family amountFaculty with family amount + GSTAccomadation Requirment - PCOA Members *SingleDoubleAccomadation Requirment - Non-PCOA Members *SingleDoubleAre you coming with Family/Alone? *Alonewith FamilyHOD Letter *Choose FileNo file chosenDelete uploaded fileHow many members with you?How many family members above age 18 *How many person between age 12 to 18 yrs?? *How many person Between age 6 - 12 Yrs? *Accompanying person infoNameAgeRelationSpouseDaughterSonFriendTotal Registration Fee(PCOA)GST Excl.Payable Total Registration Fee(PCOA) including GSTTotal Registration Fee(PCOA)GST Excl.Payable Total Registration Fee(PCOA) including GSTTotal Registration Fee(PCOA)GST Excl.Payable Total Registration Fee(PCOA) including GSTTotal Registration Fee(PCOA)GST Excl.Payable Total Registration Fee(PCOA) including GSTTotal Registration Fee(PCOA)GST Excl.Payable Total Registration Fee(PCOA) including GSTPayment DetailsPCOA Payment DetailsAccount name- Pimpri Chinchwad Orthopaedic Association Account Number- 07230100026627 Bank name- Bank of Baroda Branch- Pimpri Chinchwad, Pune IFSC code- BARB0CHINCH (fifth character is zero) GST number- 27AAETP1404B1Z4 UPI- pimpr94200@barodampayTransanction No./Cheque No. *Upload Cheque Photo/ Transaction Screenshot *Choose FileNo file chosenDelete uploaded fileRegisterPlease do not fill in this field.