AGM 2019 Registration Form
Date: 4 May 2019
Venue: World Trade Centre, 38th Floor, 280 Gloucester Road, Causeway Bay, Hong Kong
Time: 4:30 pm - 10:00 pm
Deadline for registration: 4th April, 2019
1. Name (Surname first) *
Your answer
2. Hospital / Institution *
Your answer
3. Department / Unit *
Your answer
4. Rank *
Your answer
5. Membership *
6. Registration for *
7. Group Registration (Please type the participants' name, hospital and email to be seated under your table clearly)
Your answer
8. Please indicate your participation *
9. Email *
Your answer
10. Contact Phone No. *
Your answer
Remark: Your registration is considered to be valid to AGM until you had deposit of HK$200 registration fee per member into HKICNA Hang Seng Bank Account: 291-224251-001 and WhatsApp the deposit slip to: 93566353 ** Remember to put 1. your name, 2. hospital and 3. phone on the deposit slip.**
This Email is sent from HKICNA to the intended recipients whose data are recorded in the HKICNA database for future correspondence.
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