ICICAS 2017 Registration

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Online Registration download_registration_form

DELEGATE’S INFORMATION (Information will be used for Name Badge and Certificate Printing)

Salutation*
Full Name*
Profession*
MCR No.*
SNB Reg. No*
Institution & Department*
Mailing Address*
Mobile No.*
-
E-mail Address*
Membership*
I would like to register for (Member) *
I would like to register for Workshop(s) (Member)
I would like to register for (Non-Member)*
I would like to register for Workshop(s) (Non-Member)
Selection of Workshop (Please TICK accordingly)*
Total Amount Payable
Mode of Payment*

CHEQUE PAYMENT

Cheque / Bank Draft, in Singapore Dollars, should be crossed and made payable to “Infection Control Association (Singapore)”. Kindly write the delegate’s name on the reverse side of the Cheque / Demand Draft and mail it to our conference secretariat within 10 working days

BANK TRANSFER

Bank details will be provided in the acknowledgment email. Payment is to made within 10 working days. Please indicate delegate's name as reference when doing your remittance.

INVOICE DETAILS:

Invoice to*
Billing Address*
Contact Person*
Contact Tel*
-
Contact E-mail:*

REGISTRATION NOTES

  1. Your registration will only be confirmed upon receiving your payment. An official receipt will be sent to you within 10 working days upon receiving your payment.
  2. The organizing committee regrets that registration received after 18 September 2016 might not receive their conference collaterals.

CANCELLATION POLICY

  1. Request for cancellation/replacement must be made in writing to the Conference Secretariat, latest by 18 September 2016. The organising committee regrets that requests received after this date will not be entertained.
  2. Please take note that refunds (less 20% for administrative charges) will be issued after the event.
I have read and agreed with the registration notes and cancellation policy*