IRIA Quiz Registration

01

Team Information

Enter the team and institution details.

Team Name *

Name of Hospital/Institute *

02

Student Details

Both students must be valid IRIA members.

1 Student 1

Full Name *

Mobile No. *

+91

Email ID *

IRIA Membership No. *

Radiology Course Admission Date *

2 Student 2

Full Name *

Mobile No. *

+91

Email ID *

IRIA Membership No. *

Radiology Course Admission Date *

03

Student Documents

Upload three separate documents for each student. PDF, JPG or PNG; maximum 5 MB per file.

1 Student 1 Documents

PG Admission/Allotment Letter * Admission or allotment proof Choose file IRIA Membership Certificate * Individual IRIA membership certificate Choose file

2 Student 2 Documents

PG Admission/Allotment Letter * Admission or allotment proof Choose file IRIA Membership Certificate * Individual IRIA membership certificate Choose file

04

Review & Confirm

Please verify every detail before final submission.

Nothing is submitted until you click Confirm & Submit.

Team Information

Team Name: —
Hospital/Institute: —

Student 1

Name: —
Mobile: —
Email: —
IRIA Membership No.: —
Admission Date: —

Student 1 Documents

PG Admission/Allotment Letter—
IRIA Membership Certificate—

Student 2

Name: —
Mobile: —
Email: —
IRIA Membership No.: —
Admission Date: —

Student 2 Documents

PG Admission/Allotment Letter—
IRIA Membership Certificate—