CSSD Registration Salutation*Select SalutationProfA/ProfDrMrMrsMdmMs Full Name*First/Given NameLast/Surname Profession*Select ProfessionDoctorNurseAllied HealthOthers MCR/SNB No. Institution/Department* Designation* Mailing Address (For posting of Certificate)* Street Address City State / Province / Region Postal / Zip Code AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo (Brazzaville)Costa RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZambiaZimbabwe Country Contact No.* Fax Email* Registration Fee*ICA(S) MemberNon ICA(S) Member Total Payment Options*Cheque / Bank DraftPayNowBank TransferInvoice / SponsorCheque/Bank DraftAll course fees can be made by cheques or bank draft, made payable to “Infection Control Association (Singapore)”. Cheques or Bank Drafts are to be mailed to the Secretariat. All payment is to be made in SINGAPORE DOLLARS and a receipt will be issued within 10 days of payment. Kindly write the delegate’s name on the reverse side of the Cheque / Bank Draft and mail it to our conference secretariat.PayNowUEN: T00SS0019KKindly email a screenshot of the transaction to secretariat@icas.org.sg for verification purposes.Bank TransferTransfer the payment with bank details as follows:Bank Account Name: Infection Control Association (Singapore)Bank Account Number: 028-011124-0Name of Beneficiary Bank: DBSKindly email a copy of the transaction slip top secretariat@icas.org.sg for verification purpose.Invoice / Sponsor Co. / Institution* Address* Street Address Postal / Zip Code Department* Contact Person* Contact No. * Email *Registration NotesYour 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.ICAS Members need to be active members for more than 6 months in order to enjoy course fees discount.Cancellation PolicyRequest for cancellation/replacement must be made in writing to the Conference Secretariat,latest by 31st May 2021. The organising committee regrets that requests received after this date will not be entertained.75% of the course fees will be refunded upon successful cancellation within two months after the course.SubmitReset
