IOMPS2019 Delegate Registration Form
Salutation *
Delegate Full Name *
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Email Address *
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Position *
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Institution *
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Address *
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Country *
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Contact Number *
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Delegate Category and Course Fee *
Are you submitting an oral / poster abstract? *
Will you be joining the pre-symposium / concurrent courses during the symposium? *
There will be a) FRCR Clinical Oncology Part 1 Medical Physics Course which runs concurently with part of the symposium. This course is designed for Oncology Trainees who are attempting the UK Fellowship of Royal College of Radiologists in Clinical Oncology examination. b) Pre-Symposium FRCR Clinical Oncology Part 2B Course on the 26th and 27th February 2019, designed for Oncology Trainees who wish to take the Part 2B UK Fellowship Examination.
Will you be interested to attend Conference Gala Dinner on Saturday 2nd March 2019? *
Delegates have the option to bring additional guest(s) for the Gala Dinner on the 2nd March 2019 at additional rates as below *
For each additional Adult Guest : RM120 per pax For each additional Child Guest (Age 4-11) : RM70 per pax
Dietary Preferences *
All food served during Symposium is Halal
Your preferred time and date to arrive for Registration *
Preferred Payment Method for Delegate Fee *
If you are a sponsored delegate, kindly enter your sponsorship code
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By ticking "Yes" below, I hereby confirm my attendance to the AMDI International Oncology & Medical Physics Symposium 2019
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