Registration Form

For registered dermatologists only. Credentials will be verified by the backend team and final confirmation will be sent.

Registration Form AIM 2026

Full Name

Qualification

Designation

Mobile Number

IADVL Number

Address

City

State

Zip Code

Country

Do you want to opt for Conference Residential Registration Package ?

Conference Residential Registration Package

Select Residential Category (Including GST)

Do you want to register for Workshops?

Do you want to opt for Combo Package (Workshop + Conference)?

Select Special Conference Fee Option

Conference Registration

Conference Registration (FREE)

Select Delegate Category

For residents upload HOD letter, For ADMIRE Fellow, upload proof of fellowship (payment receipt or certificate)

Choose File

Do you want to register for Workshops?

Payment Mode

Bank Details
Bank Name	ICICI Bank Ltd.
A/C Name	M/S ADMIRE ACADEMY LLP
A/C Number	001105042306
IFSC Code	ICIC0000011
Branch	Ground Floor, Shop No. 1 to 3, Beeta CHS Ltd, DLH Plaza, 54-A, S.V. Road, Andheri (W) Mumbai - 400058

For payments by Credit/Debit Card:

Visit our payment portal, and then kindly come back to this page to submit proof of your transaction below with this form.

Total Payable Amount

Upload Payment Receipt

Choose File