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Registrations |Natural Products Conferences 2025 | Natural Medicine Conference | Traditional Medicine Conferences | Medicinal Plants Conferences | Homeopathy Conferences | Naturopathy Conferences | Tokyo Conference | Japan Conference | CME Conference | CPD Conference | Top Traditional medicine conference | Top Herbal medicine conferences | Alternative medicine conference | Japan Top Conference | Medicinal Plants Event
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--> </div> <style> #app_disp_styles { color: white; font: 15px arial; font-weight: 500; padding: 5px 6px; margin: 10px; width: 124px; background: #0b0988; z-index: 101; border-radius: 6px; left: 0; border: 5px solid #fff; border-style: outset; } .a_icon_android { background: #00b4ff; text-align: center; display: inline-block; padding: 6px 5px; border-radius: 5px; margin-left: 32px; } #target a { text-decoration: none; margin: 0 3px; } .a_icon_android span .fa { font-size: 30px; color: #fff; } .a_icon_apple { background: #f6941d; } </style><!-- Inner Page Banner Area Start Here --> <div class="inner-page-banner-area registration-banner"> <div class="container"> <div class="pagination-area"> <h1>Registration</h1> <div class="backrow cnt-head" style="color: #fff;"> <span class="con-location"> Apr 16-17, 2025 </span> <span class="con-location"> Tokyo, Japan</span> </div> <i><span class="edition-title cnt-head">4<sup>th</sup> International Conference on</span></i> <h1 class="main_title1 cnt-head">Natural Products, Medicinal Plants and Traditional Medicine</h1> <ul> <li><a href="https://www.longdom.com/naturalproducts">Home</a> -</li> <li>Registration</li> </ul> </div> </div> </div> <!--style="background-image: url('https://www.longdom.com/assets/conference/img/banner/3.jpg');"--> <!-- Inner Page Banner Area End Here --><style> h1{ color:white; } #registartion .form-section-block{ background:white; } </style> <!-- About Event Area Start Here --> <div class="about-event-area2"> <div class="container"> <div class="row"> <form id="registartion" role="form" method="post" action="" class="form-horizontal" enctype="multipart/form-data"> <div> <div class="form-section-block"> <div class="step-container"> <i><img src="https://www.longdom.com/assets/conference/img/img-step1of2.png" alt="step one"/></i> </div> <div id="currencies" class="martop-50"> <div class="col-xs-12 padding-0 currency-block"> <span class="finance-head"> For any registration queries and other payment methods 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registration?</a> </div> </div> </div> --> </div> <br/> <div class="table-responsive registration"> <table class="table table-bordered table-striped table-dark"> <thead> <tr> <th>Category</th> <th>Item Name</th> <th>Earlybird<br/> <span> Dec 20, 2024 </span> </th> <th>Normal<br/> <span> Feb 26, 2025 </span> </th> <th>Final<br/> <span> Apr 15, 2025 </span> </th> <th>Select</th> <th style="min-width:113px;">Qty</th> <th>Sub Total</th> </tr> </thead> <tbody id="product_list"> <tbody> </table> </div> <div class="error" id="product_error"></div> </div> <div class="form-section-block billing first"> <h3 id="bill">Billing Information</h3> <div class="billing-container registratation"> <div class="row"> <div class="col-xs-4"> <div class="form-group"> <label for="title" class="control-label">Title <span class="red">*</span></label> <select class="form-control" name="billing_title" id="billing_title"> <option value="0">Select Title</option> <option value="Prof">Prof</option> <option value="Assoc Prof Dr">Assoc Prof</option> <option value="Assist Prof Dr">Assist Prof</option> <option value="Dr">Dr</option> <option value="Mr">Mr</option> <option value="Ms">Ms</option> <option value="Mrs">Mrs</option> </select> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="fname" class="control-label">First Name <span class="red">*</span></label> <input type="text" class="form-control" name="billing_fname" id="billing_fname" value="" placeholder="Your First Name" size="40"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="lname" class="control-label notrequired">Last Name</label> <input type="text" class="form-control" name="billing_lname" id="billing_lname" value="" placeholder="Your Last Name"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="country" class="control-label">Country <span class="red">*</span></label> <select class="form-control country_name" name="billing_country" id="billing_country"> <option value= "" >Select Country</option> <option value='United States' >United States</option> <option value='United Kingdom' >United Kingdom</option> <option value='Afghanistan' >Afghanistan</option> <option value='Albania' >Albania</option> <option value='Algeria' >Algeria</option> <option value='American Samoa' >American Samoa</option> <option value='Andorra' >Andorra</option> <option value='Angola' >Angola</option> <option value='Anguilla' >Anguilla</option> <option value='Antarctica' >Antarctica</option> <option value='Antigua and Barbuda' >Antigua and Barbuda</option> <option value='Argentina' >Argentina</option> <option value='Armenia' >Armenia</option> <option value='Aruba' >Aruba</option> <option value='Australia' >Australia</option> <option value='Austria' >Austria</option> <option value='Azerbaijan' >Azerbaijan</option> <option value='Bahamas' >Bahamas</option> <option value='Bahrain' >Bahrain</option> <option value='Bangladesh' >Bangladesh</option> <option value='Barbados' >Barbados</option> <option value='Belarus' >Belarus</option> <option value='Belgium' >Belgium</option> <option value='Belize' >Belize</option> <option value='Benin' >Benin</option> <option value='Bermuda' >Bermuda</option> <option value='Bhutan' >Bhutan</option> <option value='Bolivia' >Bolivia</option> <option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option> <option value='Botswana' >Botswana</option> <option value='Bouvet Island' >Bouvet Island</option> <option value='Brazil' >Brazil</option> <option value='British Indian Ocean Territory' >British Indian Ocean Territory</option> <option value='Brunei Darussalam' >Brunei Darussalam</option> <option value='Bulgaria' >Bulgaria</option> <option value='Burkina Faso' >Burkina Faso</option> <option value='Burundi' >Burundi</option> <option value='Cambodia' >Cambodia</option> <option value='Cameroon' >Cameroon</option> <option value='Canada' >Canada</option> <option value='Canadian Nunavut Territory' >Canadian Nunavut Territory</option> <option value='Cape Verde' >Cape Verde</option> <option value='Cayman Islands' >Cayman Islands</option> <option value='Central African Republic' >Central African Republic</option> <option value='Chad' >Chad</option> <option value='Chile' >Chile</option> <option value='China' >China</option> <option value='Christmas Island' >Christmas Island</option> <option value='Cocos (Keeling Islands)' >Cocos (Keeling Islands)</option> <option value='Colombia' >Colombia</option> <option value='Comoros' >Comoros</option> <option value='Congo' >Congo</option> <option value='Cook Islands' >Cook Islands</option> <option value='Costa Rica' >Costa Rica</option> <option value='Cote D"Ivoire (Ivory Coast)' >Cote D"Ivoire (Ivory Coast)</option> <option value='Croatia (Hrvatska)' >Croatia (Hrvatska)</option> <option value='Cuba' >Cuba</option> <option value='Cyprus' >Cyprus</option> <option value='Czech Republic' >Czech Republic</option> <option value='Denmark' >Denmark</option> <option value='Djibouti' >Djibouti</option> <option value='Dominica' >Dominica</option> <option value='Dominican Republic' >Dominican Republic</option> <option value='East Timor' >East Timor</option> <option value='Ecuador' >Ecuador</option> <option value='Egypt' >Egypt</option> <option value='El Salvador' >El Salvador</option> <option value='Equatorial Guinea' >Equatorial Guinea</option> <option value='Eritrea' >Eritrea</option> <option value='Estonia' >Estonia</option> <option value='Ethiopia' >Ethiopia</option> <option value='Falkland Islands (Malvinas)' >Falkland Islands (Malvinas)</option> <option value='Faroe Islands' >Faroe Islands</option> <option value='Fiji' >Fiji</option> <option value='Finland' >Finland</option> <option value='France' >France</option> <option value='France, Metropolitan' >France, Metropolitan</option> <option value='French Guiana' >French Guiana</option> <option value='French Polynesia' >French Polynesia</option> <option value='French Southern Territories' >French Southern Territories</option> <option value='Gabon' >Gabon</option> <option value='Gambia' >Gambia</option> <option value='Georgia' >Georgia</option> <option value='Germany' >Germany</option> <option value='Ghana' >Ghana</option> <option value='Gibraltar' >Gibraltar</option> <option value='Greece' >Greece</option> <option value='Greenland' >Greenland</option> <option value='Grenada' >Grenada</option> <option value='Guadeloupe' >Guadeloupe</option> <option value='Guam' >Guam</option> <option value='Guatemala' >Guatemala</option> <option value='Guinea' >Guinea</option> <option value='Guinea-Bissau' >Guinea-Bissau</option> <option value='Guyana' >Guyana</option> <option value='Haiti' >Haiti</option> <option value='Heard and McDonald Islands' >Heard and McDonald Islands</option> <option value='Honduras' >Honduras</option> <option value='Hong Kong' >Hong Kong</option> <option value='Hungary' >Hungary</option> <option value='Iceland' >Iceland</option> <option value='India' >India</option> <option value='Indonesia' >Indonesia</option> <option value='Iran' >Iran</option> <option value='Iraq' >Iraq</option> <option value='Ireland' >Ireland</option> <option value='Israel' >Israel</option> <option value='Italy' >Italy</option> <option value='Jamaica' >Jamaica</option> <option value='Japan' >Japan</option> <option value='Jordan' >Jordan</option> <option value='Kazakhstan' >Kazakhstan</option> <option value='Kenya' >Kenya</option> <option value='Kiribati' >Kiribati</option> <option value='Korea (North)' >Korea (North)</option> <option value='Korea (South)' >Korea (South)</option> <option value='Kuwait' >Kuwait</option> <option value='Kyrgyzstan' >Kyrgyzstan</option> <option value='Laos' >Laos</option> <option value='Latvia' >Latvia</option> <option value='Lebanon' >Lebanon</option> <option value='Lesotho' >Lesotho</option> <option value='Liberia' >Liberia</option> <option value='Libya' >Libya</option> <option value='Liechtenstein' >Liechtenstein</option> <option value='Lithuania' >Lithuania</option> <option value='Luxembourg' >Luxembourg</option> <option value='Macau' >Macau</option> <option value='Macedonia' >Macedonia</option> <option value='Madagascar' >Madagascar</option> <option value='Malawi' >Malawi</option> <option value='Malaysia' >Malaysia</option> <option value='Maldives' >Maldives</option> <option value='Mali' >Mali</option> <option value='Malta' >Malta</option> <option value='Marshall Islands' >Marshall Islands</option> <option value='Martinique' >Martinique</option> <option value='Mauritania' >Mauritania</option> <option value='Mauritius' >Mauritius</option> <option value='Mayotte' >Mayotte</option> <option value='Mexico' >Mexico</option> <option value='Micronesia' >Micronesia</option> <option value='Moldova' >Moldova</option> <option value='Monaco' >Monaco</option> <option value='Mongolia' >Mongolia</option> <option value='Montserrat' >Montserrat</option> <option value='Morocco' >Morocco</option> <option value='Mozambique' >Mozambique</option> <option value='Myanmar' >Myanmar</option> <option value='Namibia' >Namibia</option> <option value='Nauru' >Nauru</option> <option value='Nepal' >Nepal</option> <option value='Netherlands' >Netherlands</option> <option value='Netherlands Antilles' >Netherlands Antilles</option> <option value='New Caledonia' >New Caledonia</option> <option value='New Zealand' >New Zealand</option> <option value='Nicaragua' >Nicaragua</option> <option value='Niger' >Niger</option> <option value='Nigeria' >Nigeria</option> <option value='Niue' >Niue</option> <option value='Norfolk Island' >Norfolk Island</option> <option value='Northern Mariana Islands' >Northern Mariana Islands</option> <option value='Norway' >Norway</option> <option value='Oman' >Oman</option> <option value='Pakistan' >Pakistan</option> <option value='Palau' >Palau</option> <option value='Palestine' >Palestine</option> <option value='Panama' >Panama</option> <option value='Papua New Guinea' >Papua New Guinea</option> <option value='Paraguay' >Paraguay</option> <option value='Peru' >Peru</option> <option value='Philippines' >Philippines</option> <option value='Pitcairn' >Pitcairn</option> <option value='Poland' >Poland</option> <option value='Portugal' >Portugal</option> <option value='Qatar' >Qatar</option> <option value='Reunion' >Reunion</option> <option value='Romania' >Romania</option> <option value='Russian Federation' >Russian Federation</option> <option value='Rwanda' >Rwanda</option> <option value='S. Georgia and S. Sandwich Isls.' >S. Georgia and S. Sandwich Isls.</option> <option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option> <option value='Saint Lucia' >Saint Lucia</option> <option value='Saint Vincent and The Grenadines' >Saint Vincent and The Grenadines</option> <option value='Samoa' >Samoa</option> <option value='San Marino' >San Marino</option> <option value='Sao Tome and Principe' >Sao Tome and Principe</option> <option value='Saudi Arabia' >Saudi Arabia</option> <option value='Senegal' >Senegal</option> <option value='Serbia' >Serbia</option> <option value='Seychelles' >Seychelles</option> <option value='Sierra Leone' >Sierra Leone</option> <option value='Singapore' >Singapore</option> <option value='Slovak Republic' >Slovak Republic</option> <option value='Slovenia' >Slovenia</option> <option value='Solomon Islands' >Solomon Islands</option> <option value='Somalia' >Somalia</option> <option value='South Africa' >South Africa</option> <option value='Spain' >Spain</option> <option value='Sri Lanka' >Sri Lanka</option> <option value='St. Helena' >St. Helena</option> <option value='St. Pierre and Miquelon' >St. Pierre and Miquelon</option> <option value='Sudan' >Sudan</option> <option value='Suriname' >Suriname</option> <option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands</option> <option value='Swaziland' >Swaziland</option> <option value='Sweden' >Sweden</option> <option value='Switzerland' >Switzerland</option> <option value='Syria' >Syria</option> <option value='Taiwan' >Taiwan</option> <option value='Tajikistan' >Tajikistan</option> <option value='Tanzania' >Tanzania</option> <option value='Thailand' >Thailand</option> <option value='Togo' >Togo</option> <option value='Tokelau' >Tokelau</option> <option value='Tonga' >Tonga</option> <option value='Trinidad and Tobago' >Trinidad and Tobago</option> <option value='Tunisia' >Tunisia</option> <option value='Turkey' >Turkey</option> <option value='Turkmenistan' >Turkmenistan</option> <option value='Turks and Caicos Islands' >Turks and Caicos Islands</option> <option value='Tuvalu' >Tuvalu</option> <option value='US Minor Outlying Islands' >US Minor Outlying Islands</option> <option value='Uganda' >Uganda</option> <option value='Ukraine' >Ukraine</option> <option value='United Arab Emirates' >United Arab Emirates</option> <option value='Uruguay' >Uruguay</option> <option value='Uzbekistan' >Uzbekistan</option> <option value='Vanuatu' >Vanuatu</option> <option value='Vatican City State (Holy See)' >Vatican City State (Holy See)</option> <option value='Venezuela' >Venezuela</option> <option value='Viet Nam' >Viet Nam</option> <option value='Virgin Islands (British)' >Virgin Islands (British)</option> <option value='Wallis and Futuna Islands' >Wallis and Futuna Islands</option> <option value='Western Sahara' >Western Sahara</option> <option value='Yemen' >Yemen</option> <option value='Yugoslavia' >Yugoslavia</option> <option value='Zaire' >Zaire</option> <option value='Zambia' >Zambia</option> <option value='Zimbabwe' >Zimbabwe</option> <!-- <option value="United States">United States</option> <option value="United Kingdom">United Kingdom</option> <option value="Afghanistan">Afghanistan</option> <option value="Albania">Albania</option> <option value="Algeria">Algeria</option> <option value="American Samoa">American Samoa</option> <option value="Andorra">Andorra</option> <option value="Angola">Angola</option> <option value="Anguilla">Anguilla</option> <option value="Antarctica">Antarctica</option> <option value="Antigua and Barbuda">Antigua and Barbuda</option> <option value="Argentina">Argentina</option> <option value="Armenia">Armenia</option> <option value="Aruba">Aruba</option> <option value="Australia">Australia</option> <option value="Austria">Austria</option> <option value="Azerbaijan">Azerbaijan</option> <option value="Bahamas">Bahamas</option> <option value="Bahrain">Bahrain</option> <option value="Bangladesh">Bangladesh</option> <option value="Barbados">Barbados</option> <option value="Belarus">Belarus</option> <option value="Belgium">Belgium</option> <option value="Belize">Belize</option> <option value="Benin">Benin</option> <option value="Bermuda">Bermuda</option> <option value="Bhutan">Bhutan</option> <option value="Bolivia">Bolivia</option> <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option> <option value="Botswana">Botswana</option> <option value="Bouvet Island">Bouvet Island</option> <option value="Brazil">Brazil</option> <option value="British Indian Ocean Territory">British Indian Ocean Territory</option> <option value="Brunei Darussalam">Brunei Darussalam</option> <option value="Bulgaria">Bulgaria</option> <option value="Burkina Faso">Burkina Faso</option> <option value="Burundi">Burundi</option> <option value="Cambodia">Cambodia</option> <option value="Cameroon">Cameroon</option> <option value="Canada">Canada</option> <option value="Canadian Nunavut Territory">Canadian Nunavut Territory</option> <option value="Cape Verde">Cape Verde</option> <option value="Cayman Islands">Cayman Islands</option> <option value="Central African Republic">Central African Republic</option> <option value="Chad">Chad</option> <option value="Chile">Chile</option> <option value="China">China</option> <option value="Christmas Island">Christmas Island</option> <option value="Cocos (Keeling Islands)">Cocos (Keeling Islands)</option> <option value="Colombia">Colombia</option> <option value="Comoros">Comoros</option> <option value="Congo">Congo</option> <option value="Cook Islands">Cook Islands</option> <option value="Costa Rica">Costa Rica</option> <option value="Cote D'Ivoire (Ivory Coast)">Cote D'Ivoire (Ivory Coast)</option> <option value="Croatia (Hrvatska)">Croatia (Hrvatska)</option> <option value="Cuba">Cuba</option> <option value="Cyprus">Cyprus</option> <option value="Czech Republic">Czech Republic</option> <option value="Denmark">Denmark</option> <option value="Djibouti">Djibouti</option> <option value="Dominica">Dominica</option> <option value="Dominican Republic">Dominican Republic</option> <option value="East Timor">East Timor</option> <option value="Ecuador">Ecuador</option> <option value="Egypt">Egypt</option> <option value="El Salvador">El Salvador</option> <option value="Equatorial Guinea">Equatorial Guinea</option> <option value="Eritrea">Eritrea</option> <option value="Estonia">Estonia</option> <option value="Ethiopia">Ethiopia</option> <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option> <option value="Faroe Islands">Faroe Islands</option> <option value="Fiji">Fiji</option> <option value="Finland">Finland</option> <option value="France">France</option> <option value="France, Metropolitan">France, Metropolitan</option> <option value="French Guiana">French Guiana</option> <option value="French Polynesia">French Polynesia</option> <option value="French Southern Territories">French Southern Territories</option> <option value="Gabon">Gabon</option> <option value="Gambia">Gambia</option> <option value="Georgia">Georgia</option> <option value="Germany">Germany</option> <option value="Ghana">Ghana</option> <option value="Gibraltar">Gibraltar</option> <option value="Greece">Greece</option> <option value="Greenland">Greenland</option> <option value="Grenada">Grenada</option> <option value="Guadeloupe">Guadeloupe</option> <option value="Guam">Guam</option> <option value="Guatemala">Guatemala</option> <option value="Guinea">Guinea</option> <option value="Guinea-Bissau">Guinea-Bissau</option> <option value="Guyana">Guyana</option> <option value="Haiti">Haiti</option> <option value="Heard and McDonald Islands">Heard and McDonald Islands</option> <option value="Honduras">Honduras</option> <option value="Hong Kong">Hong Kong</option> <option value="Hungary">Hungary</option> <option value="Iceland">Iceland</option> <option value="India">India</option> <option value="Indonesia">Indonesia</option> <option value="Iran">Iran</option> <option value="Iraq">Iraq</option> <option value="Ireland">Ireland</option> <option value="Israel">Israel</option> <option value="Italy">Italy</option> <option value="Jamaica">Jamaica</option> <option value="Japan">Japan</option> <option value="Jordan">Jordan</option> <option value="Kazakhstan">Kazakhstan</option> <option value="Kenya">Kenya</option> <option value="Kiribati">Kiribati</option> <option value="Korea (North)">Korea (North)</option> <option value="Korea (South)">Korea (South)</option> <option value="Kuwait">Kuwait</option> <option value="Kyrgyzstan">Kyrgyzstan</option> <option value="Laos">Laos</option> <option value="Latvia">Latvia</option> <option value="Lebanon">Lebanon</option> <option value="Lesotho">Lesotho</option> <option value="Liberia">Liberia</option> <option value="Libya">Libya</option> <option value="Liechtenstein">Liechtenstein</option> <option value="Lithuania">Lithuania</option> <option value="Luxembourg">Luxembourg</option> <option value="Macau">Macau</option> <option value="Macedonia">Macedonia</option> <option value="Madagascar">Madagascar</option> <option value="Malawi">Malawi</option> <option value="Malaysia">Malaysia</option> <option value="Maldives">Maldives</option> <option value="Mali">Mali</option> <option value="Malta<">Malta</option> <option value="Marshall Islands">Marshall Islands</option> <option value="Martinique">Martinique</option> <option value="Mauritania">Mauritania</option> <option value="Mauritius">Mauritius</option> <option value="Mayotte">Mayotte</option> <option value="Mexico">Mexico</option> <option value="Micronesia">Micronesia</option> <option value="Moldova">Moldova</option> <option value="Monaco">Monaco</option> <option value="Mongolia">Mongolia</option> <option value="Montserrat">Montserrat</option> <option value="Morocco">Morocco</option> <option value="Mozambique">Mozambique</option> <option value="Myanmar">Myanmar</option> <option value="Namibia">Namibia</option> <option value="Nauru">Nauru</option> <option value="Nepal">Nepal</option> <option value="Netherlands">Netherlands</option> <option value="Netherlands Antilles">Netherlands Antilles</option> <option value="New Caledonia">New Caledonia</option> <option value="New Zealand">New Zealand</option> <option value="Nicaragua">Nicaragua</option> <option value="Niger">Niger</option> <option value="Nigeria">Nigeria</option> <option value="Niue">Niue</option> <option value="Norfolk Island">Norfolk Island</option> <option value="Northern Mariana Islands">Northern Mariana Islands</option> <option value="Norway">Norway</option> <option value="Oman">Oman</option> <option value="Pakistan">Pakistan</option> <option value="Palau">Palau</option> <option value="Panama">Panama</option> <option value="Papua New Guinea">Papua New Guinea</option> <option value="Paraguay">Paraguay</option> <option value="Peru">Peru</option> <option value="Philippines">Philippines</option> <option value="Pitcairn">Pitcairn</option> <option value="Poland">Poland</option> <option value="Portugal">Portugal</option> <option value="Qatar">Qatar</option> <option value="Reunion">Reunion</option> <option value="Romania">Romania</option> <option value="Russian Federation">Russian Federation</option> <option value="Rwanda">Rwanda</option> <option value="S. Georgia and S. Sandwich Isls.">S. Georgia and S. Sandwich Isls.</option> <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option> <option value="Saint Lucia">Saint Lucia</option> <option value="Saint Vincent and The Grenadines">Saint Vincent and The Grenadines</option> <option value="Samoa">Samoa</option> <option value="San Marino">San Marino</option> <option value="Sao Tome and Principe">Sao Tome and Principe</option> <option value="Saudi Arabia">Saudi Arabia</option> <option value="Senegal">Senegal</option> <option value="Serbia">Serbia</option> <option value="Seychelles">Seychelles</option> <option value="Sierra Leone">Sierra Leone</option> <option value="Singapore">Singapore</option> <option value="Slovak Republic">Slovak Republic</option> <option value="Slovenia">Slovenia</option> <option value="Solomon Islands">Solomon Islands</option> <option value="Somalia">Somalia</option> <option value="South Africa">South Africa</option> <option value="Spain">Spain</option> <option value="Sri Lanka">Sri Lanka</option> <option value="St. Helena">St. Helena</option> <option value="St. Pierre and Miquelon">St. Pierre and Miquelon</option> <option value="Sudan">Sudan</option> <option value="Suriname">Suriname</option> <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option> <option value="Swaziland">Swaziland</option> <option value="Sweden">Sweden</option> <option value="Switzerland">Switzerland</option> <option value="Syria">Syria</option> <option value="Taiwan">Taiwan</option> <option value="Tajikistan">Tajikistan</option> <option value="Tanzania">Tanzania</option> <option value="Thailand">Thailand</option> <option value="Togo">Togo</option> <option value="Tokelau">Tokelau</option> <option value="Tonga">Tonga</option> <option value="Trinidad and Tobago">Trinidad and Tobago</option> <option value="Tunisia">Tunisia</option> <option value="Turkey">Turkey</option> <option value="Turkmenistan">Turkmenistan</option> <option value="Turks and Caicos Islands">Turks and Caicos Islands</option> <option value="Tuvalu">Tuvalu</option> <option value="US Minor Outlying Islands">US Minor Outlying Islands</option> <option value="Uganda">Uganda</option> <option value="Ukraine">Ukraine</option> <option value="United Arab Emirates">United Arab Emirates</option> <option value="United Kingdom">United Kingdom</option> <option value="United States">United States</option> <option value="Uruguay">Uruguay</option> <option value="Uzbekistan">Uzbekistan</option> <option value="Vanuatu">Vanuatu</option> <option value="Vatican City State (Holy See)">Vatican City State (Holy See)</option> <option value="Venezuela">Venezuela</option> <option value="Viet Nam">Viet Nam</option> <option value="Virgin Islands (British)">Virgin Islands (British)</option> <option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option> <option value="Western Sahara">Western Sahara</option> <option value="Yemen">Yemen</option> <option value="Yugoslavia">Yugoslavia</option> <option value="Zaire">Zaire</option> <option value="Zambia">Zambia</option> <option value="Zimbabwe">Zimbabwe</option> --> </select> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="lname" class="control-label ">City</label> <input type="text" class="form-control" name="billing_city" id="billing_city" value="" placeholder="City"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="lname" class="control-label ">State</label> <input type="text" class="form-control" name="billing_state" id="billing_state" value="" placeholder="State"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="email" class="control-label">Email <span class="red">*</span></label> <input type="email" class="form-control" name="billing_email" id="billing_email" value="" placeholder="Your email"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="phno" class="control-label">Mobile No <span class="red">*</span></label> <input type="tel" class="form-control" id="billing_contact_no" name="billing_contact_no" value="" placeholder="Mobile Number"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="address" class="control-label">Postal Address</label> <textarea rows="3" class="form-control" id="billing_address" name="billing_address"></textarea> <div class="error"></div> </div> </div> </div> </div> </div> <div class="form-section-block billing"> <h3 id="ship">Shipping Information</h3> <div class="billing-container registratation"> <div class="row"> <div class="col-xs-12"> <div class="form-group copy-btn"> <div class="checkbox1"><i><input type="checkbox" class="copy-address" value="68" id="copy_billing"></i></div> <span>Copy from Billing Address</span> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="title" class="control-label">Title <span class="red">*</span></label> <select class="form-control" name="shipping_title" id="shipping_title"> <option value="">Select Title</option> <option value="Prof">Prof</option> <option value="Assoc Prof Dr">Assoc Prof</option> <option value="Assist Prof Dr">Assist Prof</option> <option value="Dr">Dr</option> <option value="Mr">Mr</option> <option value="Ms">Ms</option> <option value="Mrs">Mrs</option> </select> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="fname" class="control-label">First Name <span class="red">*</span></label> <input type="text" class="form-control" name="shipping_fname" id="shipping_fname" value="" placeholder="Your First Name" size="40"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="lname" class="control-label notrequired">Last Name</label> <input type="text" class="form-control" name="shipping_lname" id="shipping_lname" value="" placeholder="Your Last Name"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="country" class="control-label">Country <span class="red">*</span></label> <select class="form-control country_name" name="shipping_country" id="shipping_country"> <option value= "" >Select Country</option> <option value='United States' >United States</option> <option value='United Kingdom' >United Kingdom</option> <option value='Afghanistan' >Afghanistan</option> <option value='Albania' >Albania</option> <option value='Algeria' >Algeria</option> <option value='American Samoa' >American Samoa</option> <option value='Andorra' >Andorra</option> <option value='Angola' >Angola</option> <option value='Anguilla' >Anguilla</option> <option value='Antarctica' >Antarctica</option> <option value='Antigua and Barbuda' >Antigua and Barbuda</option> <option value='Argentina' >Argentina</option> <option value='Armenia' >Armenia</option> <option value='Aruba' >Aruba</option> <option value='Australia' >Australia</option> <option value='Austria' >Austria</option> <option value='Azerbaijan' >Azerbaijan</option> <option value='Bahamas' >Bahamas</option> <option value='Bahrain' >Bahrain</option> <option value='Bangladesh' >Bangladesh</option> <option value='Barbados' >Barbados</option> <option value='Belarus' >Belarus</option> <option value='Belgium' >Belgium</option> <option value='Belize' >Belize</option> <option value='Benin' >Benin</option> <option value='Bermuda' >Bermuda</option> <option value='Bhutan' >Bhutan</option> <option value='Bolivia' >Bolivia</option> <option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option> <option value='Botswana' >Botswana</option> <option value='Bouvet Island' >Bouvet Island</option> <option value='Brazil' >Brazil</option> <option value='British Indian Ocean Territory' >British Indian Ocean Territory</option> <option value='Brunei Darussalam' >Brunei Darussalam</option> <option value='Bulgaria' >Bulgaria</option> <option value='Burkina Faso' >Burkina Faso</option> <option value='Burundi' >Burundi</option> <option value='Cambodia' >Cambodia</option> <option value='Cameroon' >Cameroon</option> <option value='Canada' >Canada</option> <option value='Canadian Nunavut Territory' >Canadian Nunavut Territory</option> <option value='Cape Verde' >Cape Verde</option> <option value='Cayman Islands' >Cayman Islands</option> <option value='Central African Republic' >Central African Republic</option> <option value='Chad' >Chad</option> <option value='Chile' >Chile</option> <option value='China' >China</option> <option value='Christmas Island' >Christmas Island</option> <option value='Cocos (Keeling Islands)' >Cocos (Keeling Islands)</option> <option value='Colombia' >Colombia</option> <option value='Comoros' >Comoros</option> <option value='Congo' >Congo</option> <option value='Cook Islands' >Cook Islands</option> <option value='Costa Rica' >Costa Rica</option> <option value='Cote D"Ivoire (Ivory Coast)' >Cote D"Ivoire (Ivory Coast)</option> <option value='Croatia (Hrvatska)' >Croatia (Hrvatska)</option> <option value='Cuba' >Cuba</option> <option value='Cyprus' >Cyprus</option> <option value='Czech Republic' >Czech Republic</option> <option value='Denmark' >Denmark</option> <option value='Djibouti' >Djibouti</option> <option value='Dominica' >Dominica</option> <option value='Dominican Republic' >Dominican Republic</option> <option value='East Timor' >East Timor</option> <option value='Ecuador' >Ecuador</option> <option value='Egypt' >Egypt</option> <option value='El Salvador' >El Salvador</option> <option value='Equatorial Guinea' >Equatorial Guinea</option> <option value='Eritrea' >Eritrea</option> <option value='Estonia' >Estonia</option> <option value='Ethiopia' >Ethiopia</option> <option value='Falkland Islands (Malvinas)' >Falkland Islands (Malvinas)</option> <option value='Faroe Islands' >Faroe Islands</option> <option value='Fiji' >Fiji</option> <option value='Finland' >Finland</option> <option value='France' >France</option> <option value='France, Metropolitan' >France, Metropolitan</option> <option value='French Guiana' >French Guiana</option> <option value='French Polynesia' >French Polynesia</option> <option value='French Southern Territories' >French Southern Territories</option> <option value='Gabon' >Gabon</option> <option value='Gambia' >Gambia</option> <option value='Georgia' >Georgia</option> <option value='Germany' >Germany</option> <option value='Ghana' >Ghana</option> <option value='Gibraltar' >Gibraltar</option> <option value='Greece' >Greece</option> <option value='Greenland' >Greenland</option> <option value='Grenada' >Grenada</option> <option value='Guadeloupe' >Guadeloupe</option> <option value='Guam' >Guam</option> <option value='Guatemala' >Guatemala</option> <option value='Guinea' >Guinea</option> <option value='Guinea-Bissau' >Guinea-Bissau</option> <option value='Guyana' >Guyana</option> <option value='Haiti' >Haiti</option> <option value='Heard and McDonald Islands' >Heard and McDonald Islands</option> <option value='Honduras' >Honduras</option> <option value='Hong Kong' >Hong Kong</option> <option value='Hungary' >Hungary</option> <option value='Iceland' >Iceland</option> <option value='India' >India</option> <option value='Indonesia' >Indonesia</option> <option value='Iran' >Iran</option> <option value='Iraq' >Iraq</option> <option value='Ireland' >Ireland</option> <option value='Israel' >Israel</option> <option value='Italy' >Italy</option> <option value='Jamaica' >Jamaica</option> <option value='Japan' >Japan</option> <option value='Jordan' >Jordan</option> <option value='Kazakhstan' >Kazakhstan</option> <option value='Kenya' >Kenya</option> <option value='Kiribati' >Kiribati</option> <option value='Korea (North)' >Korea (North)</option> <option value='Korea (South)' >Korea (South)</option> <option value='Kuwait' >Kuwait</option> <option value='Kyrgyzstan' >Kyrgyzstan</option> <option value='Laos' >Laos</option> <option value='Latvia' >Latvia</option> <option value='Lebanon' >Lebanon</option> <option value='Lesotho' >Lesotho</option> <option value='Liberia' >Liberia</option> <option value='Libya' >Libya</option> <option value='Liechtenstein' >Liechtenstein</option> <option value='Lithuania' >Lithuania</option> <option value='Luxembourg' >Luxembourg</option> <option value='Macau' >Macau</option> <option value='Macedonia' >Macedonia</option> <option value='Madagascar' >Madagascar</option> <option value='Malawi' >Malawi</option> <option value='Malaysia' >Malaysia</option> <option value='Maldives' >Maldives</option> <option value='Mali' >Mali</option> <option value='Malta' >Malta</option> <option value='Marshall Islands' >Marshall Islands</option> <option value='Martinique' >Martinique</option> <option value='Mauritania' >Mauritania</option> <option value='Mauritius' >Mauritius</option> <option value='Mayotte' >Mayotte</option> <option value='Mexico' >Mexico</option> <option value='Micronesia' >Micronesia</option> <option value='Moldova' >Moldova</option> <option value='Monaco' >Monaco</option> <option value='Mongolia' >Mongolia</option> <option value='Montserrat' >Montserrat</option> <option value='Morocco' >Morocco</option> <option value='Mozambique' >Mozambique</option> <option value='Myanmar' >Myanmar</option> <option value='Namibia' >Namibia</option> <option value='Nauru' >Nauru</option> <option value='Nepal' >Nepal</option> <option value='Netherlands' >Netherlands</option> <option value='Netherlands Antilles' >Netherlands Antilles</option> <option value='New Caledonia' >New Caledonia</option> <option value='New Zealand' >New Zealand</option> <option value='Nicaragua' >Nicaragua</option> <option value='Niger' >Niger</option> <option value='Nigeria' >Nigeria</option> <option value='Niue' >Niue</option> <option value='Norfolk Island' >Norfolk Island</option> <option value='Northern Mariana Islands' >Northern Mariana Islands</option> <option value='Norway' >Norway</option> <option value='Oman' >Oman</option> <option value='Pakistan' >Pakistan</option> <option value='Palau' >Palau</option> <option value='Palestine' >Palestine</option> <option value='Panama' >Panama</option> <option value='Papua New Guinea' >Papua New Guinea</option> <option value='Paraguay' >Paraguay</option> <option value='Peru' >Peru</option> <option value='Philippines' >Philippines</option> <option value='Pitcairn' >Pitcairn</option> <option value='Poland' >Poland</option> <option value='Portugal' >Portugal</option> <option value='Qatar' >Qatar</option> <option value='Reunion' >Reunion</option> <option value='Romania' >Romania</option> <option value='Russian Federation' >Russian Federation</option> <option value='Rwanda' >Rwanda</option> <option value='S. Georgia and S. Sandwich Isls.' >S. Georgia and S. Sandwich Isls.</option> <option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option> <option value='Saint Lucia' >Saint Lucia</option> <option value='Saint Vincent and The Grenadines' >Saint Vincent and The Grenadines</option> <option value='Samoa' >Samoa</option> <option value='San Marino' >San Marino</option> <option value='Sao Tome and Principe' >Sao Tome and Principe</option> <option value='Saudi Arabia' >Saudi Arabia</option> <option value='Senegal' >Senegal</option> <option value='Serbia' >Serbia</option> <option value='Seychelles' >Seychelles</option> <option value='Sierra Leone' >Sierra Leone</option> <option value='Singapore' >Singapore</option> <option value='Slovak Republic' >Slovak Republic</option> <option value='Slovenia' >Slovenia</option> <option value='Solomon Islands' >Solomon Islands</option> <option value='Somalia' >Somalia</option> <option value='South Africa' >South Africa</option> <option value='Spain' >Spain</option> <option value='Sri Lanka' >Sri Lanka</option> <option value='St. Helena' >St. Helena</option> <option value='St. Pierre and Miquelon' >St. Pierre and Miquelon</option> <option value='Sudan' >Sudan</option> <option value='Suriname' >Suriname</option> <option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands</option> <option value='Swaziland' >Swaziland</option> <option value='Sweden' >Sweden</option> <option value='Switzerland' >Switzerland</option> <option value='Syria' >Syria</option> <option value='Taiwan' >Taiwan</option> <option value='Tajikistan' >Tajikistan</option> <option value='Tanzania' >Tanzania</option> <option value='Thailand' >Thailand</option> <option value='Togo' >Togo</option> <option value='Tokelau' >Tokelau</option> <option value='Tonga' >Tonga</option> <option value='Trinidad and Tobago' >Trinidad and Tobago</option> <option value='Tunisia' >Tunisia</option> <option value='Turkey' >Turkey</option> <option value='Turkmenistan' >Turkmenistan</option> <option value='Turks and Caicos Islands' >Turks and Caicos Islands</option> <option value='Tuvalu' >Tuvalu</option> <option value='US Minor Outlying Islands' >US Minor Outlying Islands</option> <option value='Uganda' >Uganda</option> <option value='Ukraine' >Ukraine</option> <option value='United Arab Emirates' >United Arab Emirates</option> <option value='Uruguay' >Uruguay</option> <option value='Uzbekistan' >Uzbekistan</option> <option value='Vanuatu' >Vanuatu</option> <option value='Vatican City State (Holy See)' >Vatican City State (Holy See)</option> <option value='Venezuela' >Venezuela</option> <option value='Viet Nam' >Viet Nam</option> <option value='Virgin Islands (British)' >Virgin Islands (British)</option> <option value='Wallis and Futuna Islands' >Wallis and Futuna Islands</option> <option value='Western Sahara' >Western Sahara</option> <option value='Yemen' >Yemen</option> <option value='Yugoslavia' >Yugoslavia</option> <option value='Zaire' >Zaire</option> <option value='Zambia' >Zambia</option> <option value='Zimbabwe' >Zimbabwe</option> <!-- <option value="United States">United States</option> <option value="United Kingdom">United Kingdom</option> <option value="Afghanistan">Afghanistan</option> <option value="Albania">Albania</option> <option value="Algeria">Algeria</option> <option value="American Samoa">American Samoa</option> <option value="Andorra">Andorra</option> <option value="Angola">Angola</option> <option value="Anguilla">Anguilla</option> <option value="Antarctica">Antarctica</option> <option value="Antigua and Barbuda">Antigua and Barbuda</option> <option value="Argentina">Argentina</option> <option value="Armenia">Armenia</option> <option value="Aruba">Aruba</option> <option value="Australia">Australia</option> <option value="Austria">Austria</option> <option value="Azerbaijan">Azerbaijan</option> <option value="Bahamas">Bahamas</option> <option value="Bahrain">Bahrain</option> <option value="Bangladesh">Bangladesh</option> <option value="Barbados">Barbados</option> <option value="Belarus">Belarus</option> <option value="Belgium">Belgium</option> <option value="Belize">Belize</option> <option value="Benin">Benin</option> <option value="Bermuda">Bermuda</option> <option value="Bhutan">Bhutan</option> <option value="Bolivia">Bolivia</option> <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option> <option value="Botswana">Botswana</option> <option value="Bouvet Island">Bouvet Island</option> <option value="Brazil">Brazil</option> <option value="British Indian Ocean Territory">British Indian Ocean Territory</option> <option value="Brunei Darussalam">Brunei Darussalam</option> <option value="Bulgaria">Bulgaria</option> <option value="Burkina Faso">Burkina Faso</option> <option value="Burundi">Burundi</option> <option value="Cambodia">Cambodia</option> <option value="Cameroon">Cameroon</option> <option value="Canada">Canada</option> <option value="Canadian Nunavut Territory">Canadian Nunavut Territory</option> <option value="Cape Verde">Cape Verde</option> <option value="Cayman Islands">Cayman Islands</option> <option value="Central African Republic">Central African Republic</option> <option value="Chad">Chad</option> <option value="Chile">Chile</option> <option value="China">China</option> <option value="Christmas Island">Christmas Island</option> <option value="Cocos (Keeling Islands)">Cocos (Keeling Islands)</option> <option value="Colombia">Colombia</option> <option value="Comoros">Comoros</option> <option value="Congo">Congo</option> <option value="Cook Islands">Cook Islands</option> <option value="Costa Rica">Costa Rica</option> <option value="Cote D'Ivoire (Ivory Coast)">Cote D'Ivoire (Ivory Coast)</option> <option value="Croatia (Hrvatska)">Croatia (Hrvatska)</option> <option value="Cuba">Cuba</option> <option value="Cyprus">Cyprus</option> <option value="Czech Republic">Czech Republic</option> <option value="Denmark">Denmark</option> <option value="Djibouti">Djibouti</option> <option value="Dominica">Dominica</option> <option value="Dominican Republic">Dominican Republic</option> <option value="East Timor">East Timor</option> <option value="Ecuador">Ecuador</option> <option value="Egypt">Egypt</option> <option value="El Salvador">El Salvador</option> <option value="Equatorial Guinea">Equatorial Guinea</option> <option value="Eritrea">Eritrea</option> <option value="Estonia">Estonia</option> <option value="Ethiopia">Ethiopia</option> <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option> <option value="Faroe Islands">Faroe Islands</option> <option value="Fiji">Fiji</option> <option value="Finland">Finland</option> <option value="France">France</option> <option value="France, Metropolitan">France, Metropolitan</option> <option value="French Guiana">French Guiana</option> <option value="French Polynesia">French Polynesia</option> <option value="French Southern Territories">French Southern Territories</option> <option value="Gabon">Gabon</option> <option value="Gambia">Gambia</option> <option value="Georgia">Georgia</option> <option value="Germany">Germany</option> <option value="Ghana">Ghana</option> <option value="Gibraltar">Gibraltar</option> <option value="Greece">Greece</option> <option value="Greenland">Greenland</option> <option value="Grenada">Grenada</option> <option value="Guadeloupe">Guadeloupe</option> <option value="Guam">Guam</option> <option value="Guatemala">Guatemala</option> <option value="Guinea">Guinea</option> <option value="Guinea-Bissau">Guinea-Bissau</option> <option value="Guyana">Guyana</option> <option value="Haiti">Haiti</option> <option value="Heard and McDonald Islands">Heard and McDonald Islands</option> <option value="Honduras">Honduras</option> <option value="Hong Kong">Hong Kong</option> <option value="Hungary">Hungary</option> <option value="Iceland">Iceland</option> <option value="India">India</option> <option value="Indonesia">Indonesia</option> <option value="Iran">Iran</option> <option value="Iraq">Iraq</option> <option value="Ireland">Ireland</option> <option value="Israel">Israel</option> <option value="Italy">Italy</option> <option value="Jamaica">Jamaica</option> <option value="Japan">Japan</option> <option value="Jordan">Jordan</option> <option value="Kazakhstan">Kazakhstan</option> <option value="Kenya">Kenya</option> <option value="Kiribati">Kiribati</option> <option value="Korea (North)">Korea (North)</option> <option value="Korea (South)">Korea (South)</option> <option value="Kuwait">Kuwait</option> <option value="Kyrgyzstan">Kyrgyzstan</option> <option value="Laos">Laos</option> <option value="Latvia">Latvia</option> <option value="Lebanon">Lebanon</option> <option value="Lesotho">Lesotho</option> <option value="Liberia">Liberia</option> <option value="Libya">Libya</option> <option value="Liechtenstein">Liechtenstein</option> <option value="Lithuania">Lithuania</option> <option value="Luxembourg">Luxembourg</option> <option value="Macau">Macau</option> <option value="Macedonia">Macedonia</option> <option value="Madagascar">Madagascar</option> <option value="Malawi">Malawi</option> <option value="Malaysia">Malaysia</option> <option value="Maldives">Maldives</option> <option value="Mali">Mali</option> <option value="Malta<">Malta</option> <option value="Marshall Islands">Marshall Islands</option> <option value="Martinique">Martinique</option> <option value="Mauritania">Mauritania</option> <option value="Mauritius">Mauritius</option> <option value="Mayotte">Mayotte</option> <option value="Mexico">Mexico</option> <option value="Micronesia">Micronesia</option> <option value="Moldova">Moldova</option> <option value="Monaco">Monaco</option> <option value="Mongolia">Mongolia</option> <option value="Montserrat">Montserrat</option> <option value="Morocco">Morocco</option> <option value="Mozambique">Mozambique</option> <option value="Myanmar">Myanmar</option> <option value="Namibia">Namibia</option> <option value="Nauru">Nauru</option> <option value="Nepal">Nepal</option> <option value="Netherlands">Netherlands</option> <option value="Netherlands Antilles">Netherlands Antilles</option> <option value="New Caledonia">New Caledonia</option> <option value="New Zealand">New Zealand</option> <option value="Nicaragua">Nicaragua</option> <option value="Niger">Niger</option> <option value="Nigeria">Nigeria</option> <option value="Niue">Niue</option> <option value="Norfolk Island">Norfolk Island</option> <option value="Northern Mariana Islands">Northern Mariana Islands</option> <option value="Norway">Norway</option> <option value="Oman">Oman</option> <option value="Pakistan">Pakistan</option> <option value="Palau">Palau</option> <option value="Panama">Panama</option> <option value="Papua New Guinea">Papua New Guinea</option> <option value="Paraguay">Paraguay</option> <option value="Peru">Peru</option> <option value="Philippines">Philippines</option> <option value="Pitcairn">Pitcairn</option> <option value="Poland">Poland</option> <option value="Portugal">Portugal</option> <option value="Qatar">Qatar</option> <option value="Reunion">Reunion</option> <option value="Romania">Romania</option> <option value="Russian Federation">Russian Federation</option> <option value="Rwanda">Rwanda</option> <option value="S. Georgia and S. Sandwich Isls.">S. Georgia and S. Sandwich Isls.</option> <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option> <option value="Saint Lucia">Saint Lucia</option> <option value="Saint Vincent and The Grenadines">Saint Vincent and The Grenadines</option> <option value="Samoa">Samoa</option> <option value="San Marino">San Marino</option> <option value="Sao Tome and Principe">Sao Tome and Principe</option> <option value="Saudi Arabia">Saudi Arabia</option> <option value="Senegal">Senegal</option> <option value="Serbia">Serbia</option> <option value="Seychelles">Seychelles</option> <option value="Sierra Leone">Sierra Leone</option> <option value="Singapore">Singapore</option> <option value="Slovak Republic">Slovak Republic</option> <option value="Slovenia">Slovenia</option> <option value="Solomon Islands">Solomon Islands</option> <option value="Somalia">Somalia</option> <option value="South Africa">South Africa</option> <option value="Spain">Spain</option> <option value="Sri Lanka">Sri Lanka</option> <option value="St. Helena">St. Helena</option> <option value="St. Pierre and Miquelon">St. Pierre and Miquelon</option> <option value="Sudan">Sudan</option> <option value="Suriname">Suriname</option> <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option> <option value="Swaziland">Swaziland</option> <option value="Sweden">Sweden</option> <option value="Switzerland">Switzerland</option> <option value="Syria">Syria</option> <option value="Taiwan">Taiwan</option> <option value="Tajikistan">Tajikistan</option> <option value="Tanzania">Tanzania</option> <option value="Thailand">Thailand</option> <option value="Togo">Togo</option> <option value="Tokelau">Tokelau</option> <option value="Tonga">Tonga</option> <option value="Trinidad and Tobago">Trinidad and Tobago</option> <option value="Tunisia">Tunisia</option> <option value="Turkey">Turkey</option> <option value="Turkmenistan">Turkmenistan</option> <option value="Turks and Caicos Islands">Turks and Caicos Islands</option> <option value="Tuvalu">Tuvalu</option> <option value="US Minor Outlying Islands">US Minor Outlying Islands</option> <option value="Uganda">Uganda</option> <option value="Ukraine">Ukraine</option> <option value="United Arab Emirates">United Arab Emirates</option> <option value="United Kingdom">United Kingdom</option> <option value="United States">United States</option> <option value="Uruguay">Uruguay</option> <option value="Uzbekistan">Uzbekistan</option> <option value="Vanuatu">Vanuatu</option> <option value="Vatican City State (Holy See)">Vatican City State (Holy See)</option> <option value="Venezuela">Venezuela</option> <option value="Viet Nam">Viet Nam</option> <option value="Virgin Islands (British)">Virgin Islands (British)</option> <option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option> <option value="Western Sahara">Western Sahara</option> <option value="Yemen">Yemen</option> <option value="Yugoslavia">Yugoslavia</option> <option value="Zaire">Zaire</option> <option value="Zambia">Zambia</option> <option value="Zimbabwe">Zimbabwe</option> --> </select> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="lname" class="control-label ">City</label> <input type="text" class="form-control" name="shipping_city" id="shipping_city" value="" placeholder="City"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="lname" class="control-label ">State</label> <input type="text" class="form-control" name="shipping_state" id="shipping_state" value="" placeholder="State"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="email" class="control-label">Email <span class="red">*</span></label> <input type="email" name="shipping_email" class="form-control" id="shipping_email" value="" placeholder="Your email"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="phno" class="control-label">Mobile No <span class="red">*</span></label> <input type="tel" class="form-control" id="shipping_contact_no" name="shipping_contact_no" value="" placeholder="Mobile Number"> <div class="error"></div> </div> </div> <div class="col-xs-4"> <div class="form-group"> <label for="address" class="control-label">Postal Address</label> <textarea rows="3" class="form-control" id="shipping_address" name="shipping_address"></textarea> <div class="error"></div> </div> </div> <div class="col-xs-12 text-center"> <div class="form-group copy-btn"> <div class="checkbox1"><i><input type="checkbox" class="copy-address" id="terms" name="terms"></i></div> <span>I have read and agree to the <a href="https://www.longdom.com/terms-and-conditions" target="_blank">terms and conditions</a></span> <div class="error" id="terms_errors"></div> </div> </div> </div> </div> <div class="btn-submit-registraion col-xs-12"> <input type="hidden" name="cart" id="cart" value="" /> <input type="hidden" name="amount" id="amount" value="" /> <input type="hidden" name="currency_symbol" id="currency_symbol" value="" /> <input type="hidden" id="stripe" value="" name="gateway_stripe" /> <input type="hidden" id = "ccavenue" value="" name="gateway_ccavenue" /> <input type="hidden" id = "razorpay" value="razorpay" name="razorpay" /> <input type="hidden" name="currency_symbol" id="currency_symbol" value="" /> <input class="btn btn-primary btn-large" type="button" value="Next >>" name="submit_registration" id="submit_registration" title="Please click on next to verify your details" /> <!-- <a href="javascript:void(0);" class="btn-proceed"> <img src="https://www.longdom.com/assets/conference/img/img-proceed.png" alt="proceed button" /> </a> --> <p class="blinking" style="color:#865000;">Please click on next to verify your details</p> </div> </div> <div class="form-section-block"> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Registration Category:</span></strong></span></span></p> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Before registering, kindly ensure your registration category as per the following table.</span></span></span></p> <table border="1" cellspacing="0" class="MsoTableGrid" style="border-collapse:collapse; border:solid windowtext 1.0pt"> <tbody> <tr> <td style="height:26.35pt; vertical-align:top; width:176.8pt"> <p style="margin-left:0cm; margin-right:0cm; text-align:center"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Academic</span></span></span></p> </td> <td style="height:26.35pt; vertical-align:top; width:139.45pt"> <p style="margin-left:0cm; margin-right:0cm; text-align:center"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Business</span></span></span></p> </td> <td style="height:26.35pt; vertical-align:top; width:155.85pt"> <p style="margin-left:0cm; margin-right:0cm; text-align:center"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Student</span></span></span></p> </td> </tr> <tr> <td style="height:73.0pt; vertical-align:top; width:176.8pt"> <p style="margin-left:0cm; margin-right:0cm"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">In-training/Resident/Fellow/Basic Scientist/Allied-Health Professional</span></span></span></p> </td> <td style="height:73.0pt; vertical-align:top; width:139.45pt"> <p style="margin-left:0cm; margin-right:0cm"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Physician/Surgeon/Commercial Business (Industry)/</span> <span style="color:black">Commercial Affiliate</span></span></span></p> </td> <td style="height:73.0pt; vertical-align:top; width:155.85pt"> <p style="margin-left:0cm; margin-right:0cm"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Who are pursuing Undergraduate/Post-graduate/ PhD degree</span></span></span></p> </td> </tr> </tbody> </table> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><br /> <span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Speaker Registration Include:</span></strong></span></span></p> <ol> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Access to all sessions</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Coffee break</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Handbook & conference kit</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">A free paper abstract (For speakers)</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Lunch</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Certificate of presentation</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">20% concession on article processing charge (Discounted fee $950) in the conference supporting journals (</span></span><span style="font-family:"Times New Roman",serif"><a href="https://www.hilarispublisher.com/pharmacognosy-natural-products.html" style="color:#0563c1; text-decoration:underline"><span style="color:#3498db">Journal of Pharmacognosy & Natural Products</span></a><span style="color:black">)</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">10% concession on the registration fee for the next conference</span></span></span></span></li> </ol> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Delegate Registration Include:</span></strong></span></span></p> <ol> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Reception banquet</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">conference handbook and kit</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Access to all the programs and speakers’ sessions</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Access to all B2B meetings</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Coffee break</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Lunch</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Networking session</span></span></span></span></li> </ol> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Students Registration includes:</span></strong></span></span></p> <ol> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Reception banquet</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Students’ presentation at the conference</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Access to all the programs and speakers’ sessions</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Coffee break</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Lunch</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">conference handbook and kit</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Publication of the abstract submitted in the conference book</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">30% concession on article processing charge (Discounted fee $725) in the conference supporting journals (</span></span><span style="font-family:"Times New Roman",serif"><a href="https://www.hilarispublisher.com/pharmacognosy-natural-products.html" style="color:#0563c1; text-decoration:underline"><span style="color:#3498db">Journal of Pharmacognosy & Natural Products</span></a><span style="color:black">)</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">10% concession on the registration fee for the next conference</span></span></span></span></li> </ol> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Hurry up: 10% DISCOUNT Exclusively for Group Registrations</span></strong></span></span></p> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Join as group with minimum of 5 members and get 10% discount on each member’s registration fee. </span></span></span><br /> <span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">To take advantage of this offer, please write an email with all five names to </span>: <a href="mailto:naturalmedicine@longdomglobal.com" style="color:#0563c1; text-decoration:underline"><span style="color:#3498db">naturalmedicine@longdomglobal.com</span></a></span></span><br /> <span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">The group registration fee should be paid through a single payment.</span></span></span></p> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="color:black"><strong>Note</strong>: Group discount offer is not applicable to accommodation fees.</span></span></span></p> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Exhibitor benefits:</span></strong></span></span></p> <ol> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">One exhibit booth (Size-3X3 sqm)</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">2-page publication of the exhibitor profile in the handbook of Natural Medicine 2023</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Promotion through the conference website</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Promotional video of products during the conference sessions (Post session and Breaks)</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">One complimentary speaker registration</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Logo recognition in the scientific program, banner and flyer</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">An opportunity to sponsor 1 Poster Presentation Award</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Post conference submission of the mailing list</span></span></span></span></li> </ol> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">E-Posters:</span></strong></span></span></p> <ol> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">The amount charged for E-Posters is to display the E-Posters only on the website but not for virtual presentation or in-person presentation</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">The abstract will be published in the conference proceedings </span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">The presenter is not required to be present in person at the conference venue</span></span></span></span></li> </ol> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Accommodation Details</span></strong></span></span></p> <ol> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">All the accommodation bookings are provided in the Premium Room (Single Occupancy) at the conference venue. It includes complimentary Breakfast, Free Wi-Fi, and Early Check-in & Check-out (subjected to the availability of room)</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">You can check in and check out on any date between April 15 and April 17, 2025, depending on the number of nights you choose</span></span></span></span></li> </ol> <p style="margin-left:0cm; margin-right:0cm; text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Accommodation Booking Information</span></strong></span></span></p> <ol> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">You may choose accommodation as an add-on to your registration ticket fee</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">For a separate or additional accommodation bookings kindly write an email mentioning your required package or number of nights to </span></span><span style="font-family:"Times New Roman",serif"><a href="mailto:naturalmedicine@longdomglobal.com" style="color:#0563c1; text-decoration:underline"><span style="color:#3498db">naturalmedicine@longdomglobal.com</span></a></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Confirmation of rooms is subjected to the prior payment of the fee through wire transfer or online payment</span></span></span></span></li> <li style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif"><span style="color:black">Any changes in the standard check-in & check-out dates must be informed to us immediately after the payment</span></span></span></span></li> </ol> </div> </div> </form> </div> </div> </div> <!-- About Event Area End Here --> <script> var data = [{"ticket_id":"14627","ticket_type":"Academic","ticket_name":"Speaker Registration","ticket_status":"1","earlyPrice":"419","normalPrice":"519","finalPrice":"619","currency_code":"GBP","currency_symbol":"£"},{"ticket_id":"14627","ticket_type":"Academic","ticket_name":"Speaker Registration","ticket_status":"1","earlyPrice":"499","normalPrice":"599","finalPrice":"699","currency_code":"EUR","currency_symbol":"\u20ac"},{"ticket_id":"14627","ticket_type":"Academic","ticket_name":"Speaker 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.more-social-icon-link, .social-share-icons .add_to_calendar_container .add_to_calendar_content .more-social-icon-link { float: left; width: 100% } .add_to_calendar_container .add_to_calendar_content .add_to_calendar_header { background: #333; color: #FFF; text-transform: uppercase; padding: 10px 20px; margin-bottom: 5px; font-weight: bold; } .add_to_calendar_container .add_to_calendar_content .add_to_calendar_description { padding: 10px 20px; font-size: 14px; text-transform: none; color: #000; } .add_to_calendar_container .add_to_calendar_content .add_to_calendar_option { float: left; width: 100%; padding: 10px 20px; text-transform: none; font-size: 14px !important; top: auto !important; left: auto !important; position: static !important; margin: 0 !important; font-weight: normal !important } .add_to_calendar_container .add_to_calendar_content .add_to_calendar_option img { margin-right: 20px; float: left; height: 30px; width: 30px; } .add_to_calendar_container .add_to_calendar_content 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$('#'+post_id).addClass('active'); $('.social_posts').removeClass('active'); $(this).addClass('active'); }); $(".country_name").change(function(){ $country = $(this).val(); if($country == 'India') { $('#ccavenue').val(''); $('#stripe').val('stripe'); } else { $('#stripe').val(''); $('#ccavenue').val('ccavenue'); } }); }); </script> <!-- /*24-08-2021*/ --> <!-- <script async src="https://www.googletagmanager.com/gtag/js?id=UA-150073151-1"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'UA-150073151-1'); </script> <script async src='https://www.google-analytics.com/analytics.js' type="4bdedc79097be6bd0942144b-text/javascript"></script> --> <!-- /*24-08-2021*/ --> <!-- Google Tag Manager --> <script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], 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