WORKSHOP ON HYPNOTHERAPY
REGISTRATION FORM
Name
Gender
Male
Female
Others
Age
Mobile No
E-mail
Educational Qualification
PG Final Year/MPhil - Rs. 3000 (Psychology/Social Work)
PhD/Professional - Rs. 3500 (Psychology/Social Work/Psychiatry)
Designation
Name of Hospital/Institute
Vegetarian/Non-vegetarian
Vegetarian
Non-vegetarian