To Download Printable Document Click Here

 

FORMAT FOR SUBMITTING PROPOSAL FOR ICOG – CME PROGRAMME FOR 2004-2005

 

 

 

Name of Organizer

 

 

 

 

Institute o Organizer

 

 

 

Proposed Venue with details

 

 

 

Proposed Dates

 

 

At least 2 members of organizing committee of this workshop be fellows/ members of ICOG

 1.

 2.

 

 

Name of the organizing Committee Members

 

 

 1.

 6.

 2.

 7.

 3.

 8.

 4.

 9.

 5.

 10.

At least 2 members of the faculty of this workshop be fellows / members of ICOG.

 1.

 2.

Proposed local faculty With Designation

 1.

 2.

 3.

 4.

 5.

Suggested Invited Faculty

 1.

 2.

 3.

Proposed Subjects Topics

1.

 2.

 3.

 4.

 5.

 

Financial Outlay

 

 

 

Local Medical Bodies i.e. IMA, Obst & Gyn Society likely to join

 

 

 

Sponsored by Obst & Gyn Society

 

 Name of the Society

 

Cheque in favour of

 

 

 

Signature

 

   (Dr.                                    ,President)      (Dr.                      ,Secretary)

 

Name

 

 

 

Correspondence Address

 

 

 

 

Telephone Number

 1.

 2.

 

Fax Number