BLS COURSE - REGISTRATION FORM
BASIC LIFE SUPPORT (BLS) COURSE - FOR PROVIDER
(HEALTHCARE PROFESSIONALS & PUBLIC)

Organized by: NATIONAL HEART ASSOCIATION OF MALAYSIA
In collaboration with: MALAYSIAN SOCIETY OF CARDIOVASCULAR TECHNOLOGIST

Training venue:
National Heart Association of Malaysia, D-13A-06, Menara Suezcap 1, KL Gateway,
No.2 Jalan Kerinchi, Gerbang Kerinchi Lestari, 59200 Kuala Lumpur
Map: https://goo.gl/maps/442BJJgYGG9LTUDYA

Tel: +603 7931 7900 Email: secretariat@malaysianheart.org
Website: https://malaysianheart.org/index.php?p=highlights&a=1000

CPD POINTS UPDATE:
CPD Points approved by MMA for Doctors: 8 CPD points
CPD Points approved by LJM for Nurses: 20 CPD points
Email address *
Course Date *
Note: With the recent COVID-19 situation we will cap participation at max 15pax per class only. Date is subject to changes - for latest update please check our website www.malaysianheart.org
Full Name (as per MyKad / Passport) *
(For printing on Certificate)
MyKad No. / Passport No. (COMPULSORY TO PROVIDE) *
(FOR PASSPORT - please indicate country)
Contact No. (H/P) *
Working Place / Hospital
Previously attended BLS Course *
How did you hear about us
Category *
Payment mode *
(Payment must be made prior to course. We DO NOT accept cash on-site. Payments are STRICTLY non-refundable)
Registration Fee **normal rate *
(inclusive of 6% SST) - Registration will only be confirmed upon receipt of FULL payment
Course Booklet *
In our efforts to "GO GREEN", we will no longer provide printed copy of the course booklet on training day. However, if you wish to have the printed copy on training day, RM 5/book will be charged to you. Otherwise everyone will be receiving the download link for the booklet emailed to you prior to course. Please indicate your preference below:
EARLY-BIRD REGISTRATION FEE
EARLY-BIRD REGISTRATION FEE @RM 280/PERSON. Cut-off date/time of payment will be advised via email by secretariat. Please check website (http://bit.ly/NHAM_BLS) for more information.
SPECIAL RATE FOR GROUP REGISTRATION
If you have a group of minimum 5pax, you may ask secretariat about our group discount rate.
For enquiries, please contact:
Secretariat, National Heart Association of Malaysia (MS. AMIRAH)
Website: www.malaysianheart.org
Email: secretariat@malaysianheart.org
Tel: 03-7931 7900

PLEASE NOTE THAT REGISTRATION WILL ONLY BE CONFIRMED UPON RECEIPT OF FULL PAYMENT. STRICTLY NO WALK-INS ALLOWED, PRE-REGISTRATION IS REQUIRED.
A copy of your responses will be emailed to the address you provided.
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