Manipal Journal of Pharmaceutical SciencesManipal University

SUBSCRIPTION FORM

Subscriber’s Name (BLOCK LETTERS):__________________________________________________________ Institution: ______________________________________________________________________________ Mailing Address: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ City: _____________________________________ State: _________________________________________ Country: __________________________________ Pin code: ______________________________________ E-mail: __________________________________________________________________________________ Telephone (with STD code): ________________ Office: ___________________________________________ Mobile phone: ____________________________________________________________________________

Enclosed please find DD/Cheque no./Transaction ID _______________dated _____________, drawn in favour of Manipal University Journals, payable at Manipal/Udupi for `_____________ towards Individual/Institutional subscription for the journal “Manipal Journal of Pharmaceutical Sciences”.

Date: SignatureSubscription amount can also be transferred online as per the details below:Beneficiary Name & Address MANIPAL UNIVERSITY JOURNALSBank Name A/c No. A/c Type ICICI BANK LTD 007201027199 SBBranch Name & Address MANIPAL BRANCH, Kasturba Hospital Complex, Main Road, Manipal-576104, Udupi DistRTGS/NEFT IFSC Code of the branch ICIC0000072MICR Code 576229002E-mail Intimation fin.mrjournals@manipal.edu

Subscription for MJPSIndividual Institutional

One year (2 issues) ` 600 `1000Three years (6 issues) `1500 `2500Five years (10 issues) `2250 `4500

Please send the completed subscription form along with DD/Cheque to:Editor, Manipal Journal of Pharmaceutical Sciences (MJPS)Manipal College of Pharmaceutical SciencesManipal University, Manipal 576104, Karnataka, India