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Delegate Registration Form

Note: You will get a "Temporary Registration Certificate" with a "Delegate Registration Number" after submitting the form. Take a print out of that certificate and send it along with the M/O or D/D or cash ( click here for amount ) within 15 days to the Council Office. The Council will provide you with a "Coupon Number" which will confirm your "Permanent Registration". You can check it out online by using your "Delegate Registration Number".



Name of the aspiring Delegate :
Year :
College Code
( Leave this field blank if you
don't have any College Code )
:
AMCC Number
( Leave this field blank if you
don't have any AMCC Number )
:
Guardian's Name  :
Phone No. :
Mobile No. :
E-Mail ID :
Street Address :
Post Office :
Postal Index Number :
District :
State :
Country :
Name of Award :
Name of Course :
Food Habit : Veg Non-Veg


Alternative Medical Council Calcutta,
Helabot-tala(above Country Motor), Barasat, Kolkata - 700125, India
Ph. (033) 2542 5572     Fax: (033) 2542 4072

amcc@vsnl.net