47th MSR AGM and MSK Study Day

Name *

Please check your name is correct for certificate printing

Address *

Please provide full adress

Current employment *

Please state which institution/ hospital/ medical centre/ clinic you are working right now.

Phone *

Mobile Phone *

Gala dinner *

Attending

Not attending

MSR member *

Life member

Ordinary Member

Non member

Payment Options *

Please mail your receipt of payment to zaidahmaspin@gmail.com for prove of payment

Cash

Cheque

LPO (Local Purchase Order)

Telegraphic Transfer

Please select food choice *

Non vegetarian

Vegetarian

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