ENT SUMMIT 2020 DELEGATE REGISTRATION FORM
Welcome respected delegates, we are pleased to know of your interest to be a part of our ENT SUMMIT 2020. The meeting will be held in Royale Chulan Hotel Kuala Lumpur, Jalan Conlay Kuala Lumpur from 27 - 29 February 2020. You may refer to the attached table for the registration rates.
Early Bird Rate: Register AND pay by 31 January 2020.
1) all rates are inclusive of 3-days full admission to the conference, with daily lunch and coffee breaks,
2) accommodation is NOT inclusive,
3) on-site registration is NOT available.
For MY Delegates, we accept payment via online transfer or via cash/cheque deposit machine.
For International Delegates, we accept payment via telegraphic transfer or credit card. If you opt for credit card payment, please email the Secretariat for further instructions.
PAYEE / ACCOUNT NAME: PRINCE COURT MEDICAL CENTRE SDN BHD
ACCOUNT NO: 80-0106004-5
BANK: CIMB BANK
SWIFT CODE: CIBBMYKL
Please fill in the form below and provide payment proof to
(attn to Ms. Haz) in order for your registration to be confirmed.
We look forward to seeing you there!
Full Name & Title (this will be inserted in your e-cert)
Name to be printed on tag
Organisation/Hospital (please include state for MY Delegates & country for International Delegates)
IC Number for CME Points (or MY Delegates only, for International Delegates you may fill NIL)
Email Address (please provide a working email address as we will be sending your e-cert to this)
I have made payment via
MY Delegate - Online Transfer
MY Delegate - Cash/Cheque Deposit Machine
International Delegate - Telegraphic Transfer
International Delegate - Credit Card
Sponsored Delegate under Pharmaceutical Company
Normal (we will not be including beef in our menu)
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