Online Registration
Title
:
Prof
Dr
Mr
Mrs
Ms
Given name
:
Family name
:
Name on badge/certificate
:
IC or Passport No
:
Affiliated organisation:
:
Mailing Address
:
Postal Code
:
City
:
Country
:
Telephone
Mobile
:
Fax
:
Email
:
Dietary requirements (if any)
:
SGD (Singapore Dollars) - Please tick & select preferred date
NYSORA
7 May ‘10 (Fri)
8 May ‘10 (Sat)
9 May ‘10 (Sun)
Scientific Meeting
600.00
Scientific Meeting (Trainee/ Student*)
295.00
Not joining Scientific Meeting
Workshop 1 **
500.00
500.00
Workshop 2 **
FULL
350.00
Not joining Workshop
TOTAL
.00
*Please attach a letter from Head of Department to confirm your trainee/ student status
**The same workshops will be conducted on Friday and Sunday.
Payment
Credit card (VISA/MasterCard) payment is available for online registration.
Bankdraft payable to "
Ping Healthcare Pte Ltd
" and mail to:
NYSORA Asia Meeting Secretariat - Ping Healthcare Pte Ltd
5 Upper Aljunied Link, #05-05, Quartz Industrial Building, Singapore 367903
Tel: +65 6778 5620 Fax:+65 6778 1372 Email:
na2010@pinghealthcare.com
My total payment of SGD
will be made via
Bankdraft
Visa
Mastercard
Terms & Conditions
On written request, a refund will be issued, but an administration charge of SGD100 will apply.
No refunds will be made after 15 April 2010.
Registration will be closed on 15 April 2010.