NIMDAC: Online Registration

NEW MEMBERS CLICK HERE

Register here if you are an EXISTING member

Personal Information
Title
First Name*
Middle Name
Last Name*
Speciality
Email Address*
Contact Information
Office Phone Number
Home Phone Number
Mobile Phone Number
Fax Number
Pager Number
Office Address Information
Street Unit/Number
City
Province
Postal Code
Country
Home Address Information
Street Unit/Number
City
Province
Postal Code
Country

HOW TO REGISTER FOR THE JHANKAR NIGHT
To register for the Jhankar Night please fill out the form and mail it to Dr. Rakesh Kumar 65 Frybrook Cr. Richmond Hill, ON L4B4B9 or FAX 905-787-1020 or email kumar@on.aibn.com Click here for the Jhankar Night Registration form.
Click here for the 2010 Registration form.

HOW TO REGISTER FOR FAMILY DAY AND GOLF
To register for the FAMILY DAY AND GOLF please fill out the form and mail it to Dr. Rakesh Kumar 65 Frybrook Cr. Richmond Hill, ON L4B4B9 or FAX 905-787-1020 or email kumar@on.aibn.com Click here for the Family Day Registration form.
Click here for the 2010 Registration form.

HOW TO REGISTER FOR ANNUAL CME AND ANNUAL FUNCTION
To register for the Annual CME and Function please fill out the form and mail it to Dr. Rakesh Kumar 65 Frybrook Cr. Richmond Hill, ON L4B4B9 or FAX 905-787-1020 or email kumar@on.aibn.com Click here for the Annual CME form.
Click here for the 2010 Registration form.