Online Registration: Reunion - MPH Pre Conference (24th May 2017)
Master of Public Health Program, Faculty of Public Health, Mahidol University
THEME “Health in Vulnerable Population”
IMPORTANT NOTICE: Online registrations for MPH Pre-conference should be submitted by 30/04/2017, or Email to phmph@mahidol.ac.th (for more information)
Your MPH Academic Year (ปีการศึกษาที่ท่านเรียน สม.)
Your answer
Gender (เพศ)
First Name(ชื่อ)
Your answer
Middle Name
Your answer
Last/Family Name(นามสกุล)
Your answer
Organisation Name (หน่วยงานของท่าน)
Your answer
Organisation Acronym (if any)
Your answer
Job Title (ตำแหน่ง)
Your answer
Department(แผนก)
Your answer
Postal Address (Including State, Province/City, Postal Code, Country, Telephone (ที่อยู่)
Your answer
Mobile(โทร.มือถือ)
Your answer
Email
Your answer
Invitation letter request(ต้องการหนังสือเชิญหรือไม่)
Restricted food(อาหารจำเพาะ)
Payment will be conducted on-site by cash for 1,000 THB.
Thank you for your cooperation
MPH Secretariat office, Faculty of Public Health, Mahidol University, 420/1 Rajvithee Rd., Rachathewee, Bangkok, Thailand 10400
Tel. 662 354 8555, Fax. 662 354 8555 Website: www.mphmahidol.com
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