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Submitted URL: http://link.mgage.solutions/link/load/?uid=66333b637b0afa530e7b23cd-66333bb1e7e96dbd056e4672-66333b687b0afa530e7b23ce&uri=ht...
Effective URL: https://docs.google.com/forms/d/e/1FAIpQLSeouFtRg6pBnEPw0w7e6lBjVMwJuEdBDf6yyVbU0SOG5O-vTg/viewform?usp=send_form
Submission: On May 16 via manual from IN — Scanned from DE

Form analysis 1 forms found in the DOM

POST https://docs.google.com/forms/d/e/1FAIpQLSeouFtRg6pBnEPw0w7e6lBjVMwJuEdBDf6yyVbU0SOG5O-vTg/formResponse

<form action="https://docs.google.com/forms/d/e/1FAIpQLSeouFtRg6pBnEPw0w7e6lBjVMwJuEdBDf6yyVbU0SOG5O-vTg/formResponse" target="_self" method="POST" id="mG61Hd" jsmodel="TOfxwf Q91hve CEkLOc" data-shuffle-seed="-510315963303075499"
  data-clean-viewform-url="https://docs.google.com/forms/d/e/1FAIpQLSeouFtRg6pBnEPw0w7e6lBjVMwJuEdBDf6yyVbU0SOG5O-vTg/viewform?usp=send_form" data-response="%.@.]" data-dlp-data="%.@.null,false]" data-first-entry="0" data-last-entry="15"
  data-is-first-page="true">
  <div jscontroller="yUS4Lc" jsaction="rcuQ6b:rcuQ6b;UxRBlf:rcuQ6b;">
    <div jsname="o6bZLc"><input type="hidden" name="entry.1539494008" value=""><input type="hidden" name="entry.1858315252" value=""><input type="hidden" name="entry.721349203" value=""><input type="hidden" name="entry.1430192550" value=""><input
        type="hidden" name="entry.821315404" value=""><input type="hidden" name="entry.638064327" value=""><input type="hidden" name="entry.540568425" value=""><input type="hidden" name="entry.1594714596" value=""><input type="hidden"
        name="entry.200363407" value=""><input type="hidden" name="entry.429574438" value=""><input type="hidden" name="entry.1488814818" value=""><input type="hidden" name="entry.1771354495" value=""><input type="hidden" name="entry.1864310268"
        value=""></div>
  </div>
  <div class="RH5hzf RLS9Fe">
    <div class="lrKTG">
      <div class="Dq4amc">
        <div class="m7w29c O8VmIc tIvQIf"><noscript>
            <div class="HB1eCd-X3SwIb-haAclf">
              <div class="HB1eCd-X3SwIb-i8xkGf">
                <div class="tk3N6e-cXJiPb tk3N6e-cXJiPb-TSZdd tk3N6e-cXJiPb-GMvhG">Die Datei kann in Ihrem Browser nicht geöffnet werden, weil JavaScript nicht aktiviert ist. Aktivieren Sie JavaScript und laden Sie die Seite noch einmal.</div>
              </div><br>
            </div>
          </noscript>
          <div class="JH79cc RVEQke b33AEc"></div>
          <div class="N0gd6">
            <div class="ahS2Le">
              <div class="F9yp7e ikZYwf LgNcQe" dir="auto" role="heading" aria-level="1">Annual Conference 2024 - Registration Form</div>
            </div>
            <div class="cBGGJ OIC90c" dir="auto">
              <div><b>Theme&nbsp; &nbsp;: </b>S<span>afe Pharmaceuticals through Quality Excipients</span></div><b>Venue&nbsp; &nbsp; :&nbsp;</b><span>Hotel Radisson Blu Plaza, Banjara Hills, Hyderabad</span>
              <div>
                <div><b>Date&nbsp; &nbsp; &nbsp; &nbsp;:&nbsp;</b>Friday, May 31, 2024</div>
                <div>
                  <div><b>Time&nbsp; &nbsp; &nbsp; :</b>&nbsp;9:00 am to 6:00 pm</div>
                  <div><b><br></b></div>
                  <div><b>Registration Fees</b></div>
                  <div><b><br></b></div>
                  <div><span>Member&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;:</span><b>&nbsp;</b><span>Rs. 5,000</span><br></div>
                  <div>
                    <div>Non-Member&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;:&nbsp;Rs. 6,000&nbsp;&nbsp;</div>
                  </div>
                  <div><b><br></b></div>
                  <div><span>Kindly share the payment details below.</span><br></div>
                  <div><b><br></b></div>
                  <div><b>NEFT Details:</b></div>
                  <div><b>Name&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; :</b>&nbsp;<span>International Pharmaceutical Excipients Council of India</span></div>
                  <div><b>Account No&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; :</b>&nbsp;<span>33756076419</span></div>
                  <div><b>Bank Name&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; :</b>&nbsp;State Bank of India</div>
                  <div><b>Branch Name&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; :</b>&nbsp;Dalamal House, Nariman Point, Mumbai - 400021</div>
                  <div><b>Branch Code&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;:</b>&nbsp;06945</div>
                  <div><b>IFSC Code&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;:</b>&nbsp;SBIN0006945</div>
                  <div><b>Payment Remark&nbsp; &nbsp; &nbsp; &nbsp;: </b>IPEC India Annual Conference&nbsp;2024 (Full Name, Company Name)</div>
                </div>
                <div><br></div>
                <div><b>Contact us</b></div>
                <div><br></div>
                <div><b>Email&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;: </b>admin@ipecindia.org</div>
                <div><b>Mobile&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;: </b>+91<b>&nbsp;</b>9137856530</div>
                <div><b><br></b></div>
                <div><b>Kindly fill up the form for each participant.</b></div>
                <div><span><br></span></div>
                <div><span>HEC is the official Hospitality partner, if you need any assistance with respect to hotel booking at Hyderabad, kindly connect with Brijesh Mehta on
                  </span><a href="mailto:brijeshm@hechospitality.com"><span>brijeshm@hechospitality.com</span></a>&nbsp;<span>With copy to </span><a href="mailto:admin@ipecindia.org">admin@ipecindia.org</a></div>
                <div><br></div>
              </div>
            </div>
            <div jsname="F0H8Yc" class="liS6Hc"></div>
          </div>
          <div class="zAVwcb"></div>
          <div class="DqBBlb">
            <div class="Oh1Vtf">
              <div class="kesdnc" id="SMMuxb">
                <a jscontroller="A2m8uc" jsaction="rcuQ6b:npT2md; click:mAWTmb;" href="https://accounts.google.com/Login?continue=https%3A%2F%2Fdocs.google.com%2Fforms%2Fd%2Fe%2F1FAIpQLSeouFtRg6pBnEPw0w7e6lBjVMwJuEdBDf6yyVbU0SOG5O-vTg%2Fviewform%3Ffbzx%3D-510315963303075499" aria-describedby="SMMuxb">In Google anmelden</a>,
                um den Fortschritt zu speichern. <a class="TYUeKb" jscontroller="rmdjlf" jsaction="rcuQ6b:npT2md; click:xdDXgc;" role="button" tabindex="0">Weitere Informationen</a></div>
            </div>
            <div class="zAVwcb"></div>
            <div class="md0UAd" aria-hidden="true" dir="auto">*&nbsp;Gibt eine erforderliche Frage an</div>
          </div>
        </div>
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      <div class="o3Dpx" role="list">
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          <div jsmodel="CP1oW"
            data-params="%.@.[2114434272,&quot;Prefix&quot;,null,3,[[1539494008,[[&quot;Dr.&quot;,null,null,null,false],[&quot;Mr.&quot;,null,null,null,false],[&quot;Ms.&quot;,null,null,null,false]],true,null,null,null,null,null,false,null,[]]],null,null,null,null,null,null,[null,&quot;Prefix&quot;]],&quot;i1&quot;,&quot;i2&quot;,&quot;i3&quot;,false]">
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              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i1" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i4"><span class="M7eMe">Prefix</span><span class="vnumgf" id="i4" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i2"></div>
                </div>
              </div>
              <div jscontroller="liFoG" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;JIbuQc:d3sQLd;" class="vQES8d">
                <div role="listbox" aria-expanded="false" class="jgvuAb ybOdnf cGN2le t9kgXb llrsB" jscontroller="YwHGTd"
                  jsaction="click:cOuCgd(LgbsSe); keydown:I481le; keypress:Kr2w4b; mousedown:UX7yZ(LgbsSe),npT2md(preventDefault=true); mouseup:lbsD7e(LgbsSe); mouseleave:JywGue; touchstart:p6p2H(LgbsSe); touchmove:FwuNnf; touchend:yfqBxc(LgbsSe|preventDefault=true); touchcancel:JMtRjd(LgbsSe); focus:AHmuwe; blur:O22p3e;b5SvAb:TvD9Pc;"
                  jsshadow="" jsname="W85ice" aria-describedby="i2 i3" aria-labelledby="i1" aria-required="true">
                  <div jsname="LgbsSe" role="presentation">
                    <div class="ry3kXd" jsname="d9BH4c" role="presentation">
                      <div class="MocG8c HZ3kWc mhLiyf LMgvRb KKjvXb DEh1R" jsname="wQNmvb" jsaction="" data-value="" aria-selected="true" role="option" tabindex="0">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Auswählen</span>
                      </div>
                      <div class="mbHMhf" role="presentation"></div>
                      <div class="MocG8c HZ3kWc mhLiyf OIC90c LMgvRb" jsname="wQNmvb" jsaction="" data-value="Dr." aria-selected="false" role="option" tabindex="-1">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Dr.</span>
                      </div>
                      <div class="MocG8c HZ3kWc mhLiyf OIC90c LMgvRb" jsname="wQNmvb" jsaction="" data-value="Mr." aria-selected="false" role="option" tabindex="-1">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Mr.</span>
                      </div>
                      <div class="MocG8c HZ3kWc mhLiyf OIC90c LMgvRb" jsname="wQNmvb" jsaction="" data-value="Ms." aria-selected="false" role="option" tabindex="-1">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Ms.</span>
                      </div>
                    </div>
                    <div class="e2CuFe eU809d" role="presentation"></div>
                  </div>
                  <div class="OA0qNb ncFHed QXL7Te" jsaction="click:dPTK6c(wQNmvb); mousedown:uYU8jb(wQNmvb); mouseup:LVEdXd(wQNmvb); mouseover:nfXz1e(wQNmvb); touchstart:Rh2fre(wQNmvb); touchmove:hvFWtf(wQNmvb); touchend:MkF9r(wQNmvb)"
                    role="presentation" jsname="V68bde" style="display:none;" soy-skip="" ssk="6:Rxil4c"></div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i3" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[911472809,&quot;Name (First Name, Last Name)&quot;,null,0,[[721349203,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Name (First Name, Last Name)\u003cbr\u003e&quot;]],&quot;i5&quot;,&quot;i6&quot;,&quot;i7&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i5" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i8"><span class="M7eMe">Name (First Name, Last Name)<br></span><span class="vnumgf" id="i8" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i6"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i5" aria-describedby="i6 i7" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i7" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[36530199,&quot;Designation&quot;,null,0,[[1430192550,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Designation\u003cbr\u003e&quot;]],&quot;i9&quot;,&quot;i10&quot;,&quot;i11&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i9" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i12"><span class="M7eMe">Designation<br></span><span class="vnumgf" id="i12" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i10"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i9" aria-describedby="i10 i11" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i11" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[337280428,&quot;Department&quot;,null,0,[[821315404,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Department\u003cbr\u003e&quot;]],&quot;i13&quot;,&quot;i14&quot;,&quot;i15&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i13" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i16"><span class="M7eMe">Department<br></span><span class="vnumgf" id="i16" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i14"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i13" aria-describedby="i14 i15" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i15" role="alert"></div>
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          </div>
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        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[427837749,&quot;Organisation / Institute Name&quot;,null,0,[[638064327,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Organisation / Institute Name\u003cbr\u003e&quot;]],&quot;i17&quot;,&quot;i18&quot;,&quot;i19&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i17" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i20"><span class="M7eMe">Organisation / Institute Name<br></span><span class="vnumgf" id="i20" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i18"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
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                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
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                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i19" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[517219785,&quot;Mobile Number&quot;,null,0,[[540568425,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Mobile Number\u003cbr\u003e&quot;]],&quot;i21&quot;,&quot;i22&quot;,&quot;i23&quot;,false]">
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                  <div class="gubaDc OIC90c RjsPE" id="i22"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i21" aria-describedby="i22 i23" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i23" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[1344986396,&quot;Email ID&quot;,null,0,[[1594714596,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Email ID\u003cbr\u003e&quot;]],&quot;i25&quot;,&quot;i26&quot;,&quot;i27&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i25" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i28"><span class="M7eMe">Email ID<br></span><span class="vnumgf" id="i28" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i26"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i25" aria-describedby="i26 i27" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i27" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[618480201,&quot;City&quot;,null,0,[[200363407,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;City\u003cbr\u003e&quot;]],&quot;i29&quot;,&quot;i30&quot;,&quot;i31&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i29" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i32"><span class="M7eMe">City<br></span><span class="vnumgf" id="i32" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i30"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i29" aria-describedby="i30 i31" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i31" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[1687644899,&quot;State&quot;,null,0,[[429574438,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;State\u003cbr\u003e&quot;]],&quot;i33&quot;,&quot;i34&quot;,&quot;i35&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i33" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i36"><span class="M7eMe">State<br></span><span class="vnumgf" id="i36" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i34"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i33" aria-describedby="i34 i35" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i35" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[990412162,&quot;Country&quot;,null,0,[[1488814818,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Country\u003cbr\u003e&quot;]],&quot;i37&quot;,&quot;i38&quot;,&quot;i39&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i37" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i40"><span class="M7eMe">Country<br></span><span class="vnumgf" id="i40" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i38"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
                  <div class="aCsJod oJeWuf">
                    <div class="aXBtI Wic03c">
                      <div class="Xb9hP"><input type="text" class="whsOnd zHQkBf" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-labelledby="i37" aria-describedby="i38 i39" aria-disabled="false" required="" dir="auto" data-initial-dir="auto"
                          data-initial-value="">
                        <div jsname="LwH6nd" class="ndJi5d snByac" aria-hidden="true">Meine Antwort</div>
                      </div>
                      <div class="i9lrp mIZh1c"></div>
                      <div jsname="XmnwAc" class="OabDMe cXrdqd"></div>
                    </div>
                  </div>
                  <div class="LXRPh">
                    <div jsname="ty6ygf" class="ovnfwe Is7Fhb"></div>
                  </div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i39" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[170477373,&quot;Let us know your Food Preferences&quot;,null,2,[[67485951,[[&quot;Veg&quot;,null,null,null,false],[&quot;Non-Veg&quot;,null,null,null,false],[&quot;Jain&quot;,null,null,null,false]],true,null,null,null,null,null,false,null,[]]],null,null,null,null,null,null,[null,&quot;Let us know your Food Preferences\u003cbr\u003e&quot;]],&quot;i41&quot;,&quot;i42&quot;,&quot;i43&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i41" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i44"><span class="M7eMe">Let us know your Food Preferences<br></span><span class="vnumgf" id="i44" aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i42"></div>
                </div>
              </div>
              <div jscontroller="UmOCme" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;JIbuQc:RgMCxe(YlCLKb);sPvj8e:d3sQLd;TYy3Ne:RgMCxe;" class="oyXaNc" jsname="GCYh9b"><input type="hidden" name="entry.67485951_sentinel" jsname="DTMEae">
                <div jscontroller="eFy6Rc" jsaction="sPvj8e:Gh295d" jsname="cnAzRb">
                  <div class="lLfZXe fnxRtf cNDBpf" jscontroller="wPRNsd" jsshadow="" jsaction="keydown:I481le;JIbuQc:JIbuQc;rcuQ6b:rcuQ6b" jsname="wCJL8" aria-labelledby="i41" aria-describedby="i42 i43" aria-required="true" role="radiogroup"><span
                      jsslot="" role="presentation" jsname="bN97Pc" class="H2Gmcc tyNBNd">
                      <div class="SG0AAe">
                        <div class="nWQGrd zwllIb"><label for="i45" class="docssharedWizToggleLabeledContainer ajBQVb">
                            <div class="bzfPab wFGF8">
                              <div class="d7L4fc bJNwt  FXLARc aomaEc ECvBRb">
                                <div id="i45" class="Od2TWd hYsg7c" jscontroller="EcW08c"
                                  jsaction="keydown:I481le;dyRcpb:dyRcpb;click:cOuCgd; mousedown:UX7yZ; mouseup:lbsD7e; mouseenter:tfO1Yc; mouseleave:JywGue; focus:AHmuwe; blur:O22p3e; contextmenu:mg9Pef;touchstart:p6p2H; touchmove:FwuNnf; touchend:yfqBxc(preventDefault=true); touchcancel:JMtRjd;"
                                  jsshadow="" aria-label="Veg" data-value="Veg" role="radio" aria-checked="false" aria-posinset="1" aria-setsize="3" tabindex="0">
                                  <div class="x0k1lc MbhUzd"></div>
                                  <div class="uyywbd"></div>
                                  <div class="vd3tt">
                                    <div class="AB7Lab Id5V1">
                                      <div class="rseUEf nQOrEb"></div>
                                    </div>
                                  </div>
                                </div>
                              </div>
                              <div class="YEVVod">
                                <div class="ulDsOb"><span dir="auto" class="aDTYNe snByac OvPDhc OIC90c">Veg</span></div>
                              </div>
                            </div>
                          </label></div>
                        <div class="nWQGrd zwllIb"><label for="i48" class="docssharedWizToggleLabeledContainer ajBQVb">
                            <div class="bzfPab wFGF8">
                              <div class="d7L4fc bJNwt  FXLARc aomaEc ECvBRb">
                                <div id="i48" class="Od2TWd hYsg7c" jscontroller="EcW08c"
                                  jsaction="keydown:I481le;dyRcpb:dyRcpb;click:cOuCgd; mousedown:UX7yZ; mouseup:lbsD7e; mouseenter:tfO1Yc; mouseleave:JywGue; focus:AHmuwe; blur:O22p3e; contextmenu:mg9Pef;touchstart:p6p2H; touchmove:FwuNnf; touchend:yfqBxc(preventDefault=true); touchcancel:JMtRjd;"
                                  jsshadow="" aria-label="Non-Veg" data-value="Non-Veg" role="radio" aria-checked="false" aria-posinset="2" aria-setsize="3" tabindex="-1">
                                  <div class="x0k1lc MbhUzd"></div>
                                  <div class="uyywbd"></div>
                                  <div class="vd3tt">
                                    <div class="AB7Lab Id5V1">
                                      <div class="rseUEf nQOrEb"></div>
                                    </div>
                                  </div>
                                </div>
                              </div>
                              <div class="YEVVod">
                                <div class="ulDsOb"><span dir="auto" class="aDTYNe snByac OvPDhc OIC90c">Non-Veg</span></div>
                              </div>
                            </div>
                          </label></div>
                        <div class="nWQGrd zwllIb"><label for="i51" class="docssharedWizToggleLabeledContainer ajBQVb">
                            <div class="bzfPab wFGF8">
                              <div class="d7L4fc bJNwt  FXLARc aomaEc ECvBRb">
                                <div id="i51" class="Od2TWd hYsg7c" jscontroller="EcW08c"
                                  jsaction="keydown:I481le;dyRcpb:dyRcpb;click:cOuCgd; mousedown:UX7yZ; mouseup:lbsD7e; mouseenter:tfO1Yc; mouseleave:JywGue; focus:AHmuwe; blur:O22p3e; contextmenu:mg9Pef;touchstart:p6p2H; touchmove:FwuNnf; touchend:yfqBxc(preventDefault=true); touchcancel:JMtRjd;"
                                  jsshadow="" aria-label="Jain" data-value="Jain" role="radio" aria-checked="false" aria-posinset="3" aria-setsize="3" tabindex="0">
                                  <div class="x0k1lc MbhUzd"></div>
                                  <div class="uyywbd"></div>
                                  <div class="vd3tt">
                                    <div class="AB7Lab Id5V1">
                                      <div class="rseUEf nQOrEb"></div>
                                    </div>
                                  </div>
                                </div>
                              </div>
                              <div class="YEVVod">
                                <div class="ulDsOb"><span dir="auto" class="aDTYNe snByac OvPDhc OIC90c">Jain</span></div>
                              </div>
                            </div>
                          </label></div>
                      </div>
                    </span></div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i43" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[697001736,&quot;Type of Registration ? (Please select one)&quot;,null,3,[[1858315252,[[&quot;Member - Rs. 5,000/-&quot;,null,null,null,false],[&quot;Non - Member - Rs. 6,000/-&quot;,null,null,null,false],[&quot;Partner&quot;,null,null,null,false],[&quot;Committee / Speaker&quot;,null,null,null,false]],true,null,null,null,null,null,false,null,[]]],null,null,null,null,null,null,[null,&quot;Type of Registration ? (Please select one)\u003cbr\u003e&quot;]],&quot;i54&quot;,&quot;i55&quot;,&quot;i56&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i54" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i57"><span class="M7eMe">Type of Registration ? (Please select one)<br></span><span class="vnumgf" id="i57" aria-label="Pflichtfrage">
                      *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i55"></div>
                </div>
              </div>
              <div jscontroller="liFoG" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;JIbuQc:d3sQLd;" class="vQES8d">
                <div role="listbox" aria-expanded="false" class="jgvuAb ybOdnf cGN2le t9kgXb llrsB" jscontroller="YwHGTd"
                  jsaction="click:cOuCgd(LgbsSe); keydown:I481le; keypress:Kr2w4b; mousedown:UX7yZ(LgbsSe),npT2md(preventDefault=true); mouseup:lbsD7e(LgbsSe); mouseleave:JywGue; touchstart:p6p2H(LgbsSe); touchmove:FwuNnf; touchend:yfqBxc(LgbsSe|preventDefault=true); touchcancel:JMtRjd(LgbsSe); focus:AHmuwe; blur:O22p3e;b5SvAb:TvD9Pc;"
                  jsshadow="" jsname="W85ice" aria-describedby="i55 i56" aria-labelledby="i54" aria-required="true">
                  <div jsname="LgbsSe" role="presentation">
                    <div class="ry3kXd" jsname="d9BH4c" role="presentation">
                      <div class="MocG8c HZ3kWc mhLiyf LMgvRb KKjvXb DEh1R" jsname="wQNmvb" jsaction="" data-value="" aria-selected="true" role="option" tabindex="0">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Auswählen</span>
                      </div>
                      <div class="mbHMhf" role="presentation"></div>
                      <div class="MocG8c HZ3kWc mhLiyf OIC90c LMgvRb" jsname="wQNmvb" jsaction="" data-value="Member - Rs. 5,000/-" aria-selected="false" role="option" tabindex="-1">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Member - Rs. 5,000/-</span>
                      </div>
                      <div class="MocG8c HZ3kWc mhLiyf OIC90c LMgvRb" jsname="wQNmvb" jsaction="" data-value="Non - Member - Rs. 6,000/-" aria-selected="false" role="option" tabindex="-1">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Non - Member - Rs. 6,000/-</span>
                      </div>
                      <div class="MocG8c HZ3kWc mhLiyf OIC90c LMgvRb" jsname="wQNmvb" jsaction="" data-value="Partner" aria-selected="false" role="option" tabindex="-1">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Partner</span>
                      </div>
                      <div class="MocG8c HZ3kWc mhLiyf OIC90c LMgvRb" jsname="wQNmvb" jsaction="" data-value="Committee / Speaker" aria-selected="false" role="option" tabindex="-1">
                        <div class="kRoyt MbhUzd" jsname="ksKsZd"></div><span jsslot="" class="vRMGwf oJeWuf">Committee / Speaker</span>
                      </div>
                    </div>
                    <div class="e2CuFe eU809d" role="presentation"></div>
                  </div>
                  <div class="OA0qNb ncFHed QXL7Te" jsaction="click:dPTK6c(wQNmvb); mousedown:uYU8jb(wQNmvb); mouseup:LVEdXd(wQNmvb); mouseover:nfXz1e(wQNmvb); touchstart:Rh2fre(wQNmvb); touchmove:hvFWtf(wQNmvb); touchend:MkF9r(wQNmvb)"
                    role="presentation" jsname="V68bde" style="display:none;" soy-skip="" ssk="6:Rxil4c"></div>
                </div>
              </div>
              <div jsname="Rfh2Tc" class="SL4Sz" id="i56" role="alert"></div>
            </div>
          </div>
        </div>
        <div class="Qr7Oae" role="listitem">
          <div jsmodel="CP1oW"
            data-params="%.@.[2019369715,&quot;Payment Details (UTR NO/ NEFT NO) with full name, company name with date&quot;,null,0,[[1771354495,null,true,null,null,null,null,null,null,null,[]]],null,null,null,null,null,null,[null,&quot;Payment Details (UTR NO/ NEFT NO) with full name, company name with date\u003cbr\u003e&quot;]],&quot;i58&quot;,&quot;i59&quot;,&quot;i60&quot;,false]">
            <div jscontroller="sWGJ4b" jsaction="EEvAHc:yfX9oc;" jsname="WsjYwc" class="geS5n">
              <div class="z12JJ">
                <div class="M4DNQ">
                  <div id="i58" class="HoXoMd D1wxyf RjsPE" role="heading" aria-level="3" aria-describedby="i61"><span class="M7eMe">Payment Details (UTR NO/ NEFT NO) with full name, company name with date<br></span><span class="vnumgf" id="i61"
                      aria-label="Pflichtfrage"> *</span></div>
                  <div class="gubaDc OIC90c RjsPE" id="i59"></div>
                </div>
              </div>
              <div jscontroller="oCiKKc" jsaction="rcuQ6b:vZc4S;O22p3e:zjh6rb;b2trFe:eVidQc;sPvj8e:d3sQLd;AHmuwe:h06R8;" class="AgroKb">
                <div class="rFrNMe k3kHxc RdH0ib yqQS1 zKHdkd" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV" jsshadow="" jsname="YPqjbf">
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Annual Conference 2024 - Registration Form
Theme   : Safe Pharmaceuticals through Quality Excipients
Venue    : Hotel Radisson Blu Plaza, Banjara Hills, Hyderabad
Date       : Friday, May 31, 2024
Time      : 9:00 am to 6:00 pm


Registration Fees


Member                         : Rs. 5,000

Non-Member                 : Rs. 6,000  


Kindly share the payment details below.



NEFT Details:
Name                            : International Pharmaceutical Excipients
Council of India
Account No                  : 33756076419
Bank Name                  : State Bank of India
Branch Name              : Dalamal House, Nariman Point, Mumbai - 400021
Branch Code               : 06945
IFSC Code                   : SBIN0006945
Payment Remark       : IPEC India Annual Conference 2024 (Full Name, Company
Name)


Contact us


Email                           : admin@ipecindia.org
Mobile                         : +91 9137856530


Kindly fill up the form for each participant.


HEC is the official Hospitality partner, if you need any assistance with respect
to hotel booking at Hyderabad, kindly connect with Brijesh Mehta on
brijeshm@hechospitality.com With copy to admin@ipecindia.org




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