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Participant Particulars

Including country and area codes
Please include N/A if not available
Do not include hypen for IC No.
(including country and area codes)
(including country and area codes)
Meal Preference

Please state your food preference

Yes
No

REGISTRATION CATEGORY

Private doctor/ Private institution - RM 550
Public doctor/ Public institution - RM 500
Member of Medico-Legal Society of Malaysia - RM 500
Member of Malaysian Society of Anaesthesiologists/College of Anaesthesiologists - RM 500
House officer - RM 350
Public/Private Allied Health Professional - RM 350

Complimentary

Complimentary (Speaker) - RM 0
Complimentary (OC) - RM 0
Complimentary (Exhibitor) - RM 0
Total

PAYMENT METHOD

Bank Transfer
All payments are to be issued in favour of "Neudimenxion"
Name of Account: NEUDIMENXION
Account No.: 800 528 6358
Name of Bank: CIMB Bank Berhad - Jalan Rubber Branch
Address of Bank: 282, Jalan Rubber, 93400 Kuching, Sarawak
Tel: +6082-23 8072 ; Fax: +6082-23 8069
Swift Code: CIBBMYKLXXX
Email: [email protected]
Letter of Guarantee (Student)
Local Purchase Order (LPO)
Proceed with online payment via iPay88

Importance Notice:

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