REGISTRATION FORM - 9th Annual International Conference of the Saudi Critical Care Society (SCCS)
in collaboration with the Department of Critical Care Medicine at King Faisal Specialist Hospital and Research Centre - Riyadh

IMPORTANT INFORMATION:
1. Registration is not confirmed until payment is received.
2. Payment is accepted in cash at CME Office, KFSHRC
3. Cash deposit or bank transfer should be payable to: Account Name: Academic Affairs Postgraduate Funds, IBAN: SA5580000 114 608 010035171, Bank Name: Al Rajhi Bank, Bank Address: KFSHRC Branch, Takhassusi St.
4. All paid registration fees are non-refundable.

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SCFHS License Number *
Professional Title *
Gender *
Profession & Institution *
Contact Number *
E-mail Address: *
PRE-REGISTRATION (Up to 05 April 2018)
LATE/ON-SITE REGISTRATION (After 06 April 2018)
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