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38th World Congress on Military Medicine

Kuala Lumpur (Malaysia), 4 - 9 October, 2009


Registration

 

REGISTRATION
(to be printed)

Delegates Detail
Please complete in block letters
Name :
Rank :
Position :
Address :
Postcode : State :
Country : Email :
Mobile : Spouse Name :
Please tick if you are a vegetarian
* If you have more than 2 delegates, please fill in another registration form or attach a list

Administrative Contact
Contact Person : Position :
Email : Mobile :
Organisation :
Address :
Postcode : State : Country :
Tel : Fax : URL :

Registration Fees
WCMM 2009
Before1 july 2009
On/after 1 july 2009
Onsite
No. of participants
Total
ICMM
Member States
600 euros* 650 euros* 700 euros*
Non ICMM
Member States
700 euros* 750 euros* 800 euros*
Accompanying Person 150 euros* 150 euros* 200 euros*
*Bank charges will be borne by participant

Payment
Methods of payment
Company Cheque / Bank Draft / Postal Order / Money Order / Local Order
No. :
(to be made payable to "KETUA AKAUNTAN KEMENTAH")
Bank Transfer
Bank :
Affin Islamic Bank Berhad
Address :
17th Floor, Menara AFFIN, 80, Jalan Raja Chulan
50200 Kuala Lumpur
Malaysia
Account No. : 1057 1011 4709
Swift Code : PHBMMYKL
Visa
Master Card
Amex
Diners
Card Number :
Cardholder's Name :
Expiry Date : CVV2 No. (3digits) :
Amex Security Code (5 digits) :
Signature :

Terms and Conditions
  • Fees are inclusive of congress materials, access to scheduled lunches, coffee breaks, exhibition and all official functions.
  • Accompanying Persons registration fee includes access to exhibition, opening ceremony, welcome reception and gala dinner.
  • Registration is confirmed only upon receipt of full payment.
  • We reserve the right to refuse admission if payment is not received on time.
  • All cancellations must be made in writting.
  • Non attendance does not constitute a cancellation. Full fee is applicable for non attendance unless cancellation is received at least four weeks before the event.
  • A refund 50% will be made for cancellations received no less than four weeks before the event, or alternatively you may nominate a substitute.
  • No refund for cancellations received within less than 4 weeks notice.
  • The Organisers reserve the right to change event dates, venue or programme as deemed necessary and no refunds or part refunds will be made.
  • For TT and online payment please inform through fax or email.

Authorisation
Name of Authorising Executive :
Position : Department :

Signature : Date :

 

For full details and instructions, please visit :
http://wcmmkl2009.com