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About Alpcord Network

All the delegates are requested to fill up the below mentioned form to send money directly with a credit card ( VISA/ American Express Card ) using this system.

Please note the following instructions and the mandatory fields for the smooth processing of the form, i.e.

1.     Full name
2.     Conference Name  ( Kindly skip if it is individual booking )
3.     Date and Venue
4.     email address

The field will receive only INR ( Indian Rupees ). Kindly use currency converter or consult us for the exact amount to be filled.

On submission of form, you will be directed to ICICI/ American Express payment gateway, where the credit card ( VISA/ American Express ) details to be filled to complete the registration process. A Confirmation message will appear on the screen for successful payments.

Delegates who wish to register without payments will only submit once. We will revert to you at the email address mentioned in the form after we receive the form.

For any assistance please email us at globalalpcord@alpcord.com

Please complete this section carefully. The information you provide will allow us to correspond with you efficiently.
" Kindly fill up the form for registration , accommodation or tour arrangement as per the below "
Please put the conference name in the required field.
Title :
*Last Name :
*First Name :
*Nationality :
Institution :
*Address :
*City :
*Province/State :
*Country :
*Postcode :
*Phone :
Fax :
*E-mail :
Number of Accompanying Person (s) :
*Purpose of Payment : Please tick for payment applicable
Travel Tour
Convert the USD into Indian National Rupee (INR) at prevailing rates by click here >>
* Conference's Name :
* Conference's Date :
Registration Amount : INR
Hotel Name :
Period of stay : to
Total Amount : INR
Tour Amount : INR
Travel & Ticket Amount : INR
Transport Amount : INR
Airport Pickup : INR
Misc Details :
Misc Amount : INR
*Total Amount : INR
3 % handling charge : INR
Grand Total : INR
Payment Option : Visa / Master
    American Express
Security Code :
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