REGISTRATION FORM

DELEGATE DETAILS

Title :
Dato. Prof. Dr. Mr. Mrs. Ms.  
Full Name:
Affiliated Organisation /Institution :
Address :
 
State :
Postcode : Country :
Tel :
Mobile : Fax :
Email :

 

Vegetarian meals required Yes No
Opening Ceremony on 19 May 2011 Yes No
MEMS 30th Anniversary Dinner on 21 May 2011*
(*complimentary for MEMS members only) 		Yes No

 

REGISTRATION FEES (Please Tick the Appropriate boxes)

Congress Member Non-member International
Early bird (before 1st March 2011) RM 450 RM 600 USD 300
Normal (on/after 1st March 2011) RM 500 RM 650 USD 350


Pre-congress Workshop Member Non-member International
Imaging in Endocrinology RM 150 RM 250 USD 100
Clinical Teaching in Paediatric Endocrinology RM 150 RM 250 USD 100
Pre-congress Space is limited on a first-come first-serve basic

 

MEMS 30th Anniversary
Dinner 21 May 2011 		Member Non-member International
Complimentary RM 100 USD 30

NOTE: You ONLY qualify for the cheaper payment if your payment is received before the stipulated date!