EMDR Indonesia is a professional association of therapists committed to the highest standards of research and practise for the clinical use of EMDR.
Eye Movement Desensitization and Reprocessing (EMDR) PDF
Eye Movement Desensitization and Reprocessing (EMDR)

27 February-1st March 2015
New Delhi, India

Registration Form

Full Name:


Mailing address:

Mobile no:

Email address:

Please indicate (tick) your registration preference:

Pre conference (27th Feb, 2015)    | Conference (28th Feb-1st March, 2015)    | Pre conference + conference

Registration Category:
Life Member of EMDR Association / Student / Foreign Delegate / Other participant: _____________

Registration fees as per your registration category: _________

Details of payment made:
Bank Name & Place: _________
Account Name: _________
Account Number: _________
Amount: _________
Date of payment: _________

Please fill up this form, attach the electronic copy of proof of payment and email to:


Details of Conference at: www.emdrindia.org

Kindly note: Registration fee does not include accommodation    

For electronic transfer send registration payment to:
Account Name: EMDR Association
Account Number: 913020050319821
Bank Details: Axis Bank, Nariman Point, Mumbai (MH)
IFS Code: UTIB0000173

Kindly submit a print as proof of the electronic transfer (NEFT) when you arrive on day 1. Transfer charges will be liable to the sender.         
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