ATSKL 2017 Registration Form
International participant USD 50 or RM250 / person
Local participants RM200 / person
Local participant (government/non-profit organization) RM150 / person
First Name *
Your answer
Last Name
Your answer
Designation
Your answer
Organisation Name *
Your answer
Passport Number (IC for local participant) *
Your answer
Mailing Address
Your answer
Email Address *
Your answer
Contact Number
Your answer
Submit
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This form was created inside of Pusat Perubatan Universiti Malaya.