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3rd Ophthalmology Optometry Conference 2018
Cornea & Contact Lens
Aman Jaya Convention Centre, Ipoh, Perak
10th - 12th August 2018

REGISTRATION FORM
Title: Prof Assoc Prof Dr Mr Ms Others:
Full Name:
Institution/Company:
Address:
Country:
Phone:
Fax:
Mobile:
Email:
Dietary Requirements: Tick to indicate vegetarian meals are required
REGISTRATION FEES
Category By 1 Jun 2018 After 1 Jun 2018  
Government
Specialist RM 250 RM 350
-
Pre-Conference Workshop on 10 Aug 2018 (50 seats limit reached)
RM 30
-
Medical Officer
RM 150 RM 250
-
Pre-Conference Workshop on 10 Aug 2018 (50 seats limit reached)
RM 30
-
Optometrist (FULL)
RM 150 RM 250
-
Pre-Conference Workshop on 10 Aug 2018 (limited to 100 seats only)
RM 30
-
Paramedic (FULL)
RM 75 RM 175
-
Private
Specialist RM 350 RM 450
-
Pre-Conference Workshop on 10 Aug 2018 (50 seats limit reached)
RM 130
-
Medical Officer
RM 250 RM 350
-
Pre-Conference Workshop on 10 Aug 2018 (50 seats limit reached)
RM 130
-
Optometrist (FULL)
RM 250 RM 350
-
Pre-Conference Workshop on 10 Aug 2018 (limited to 100 seats only)
RM 130
-
Paramedic (FULL)
RM 175 RM 275
-
  Total
-
    Terms:
  1. Complete this form in CAPITAL letters.
  2. Registration will only be confirmed after payment has been received.
  3. No refunds or cancellations. However, a substitute delegate may be nominated upon secretariat approval.
  4. Registration fees include tea breaks, meeting materials and Certificate of Attendance.
PAYMENT SUMMARY

Please indicate your preferred method of payment

Credit Card/Online Banking

Payment to be made via iPay88

Bank-in/Telegraphic Transfer

Payee: OOC2018 (Persatuan Oftalmologi Malaysia)
Bank a/c no. : 5641 9157 3862
Bank Address : Malayan Banking Berhad
62-66, Jalan SS21/35,
Damansara Utama, 47400 PJ,
Selangor
Telephone No: 03-7728 5106, 7729 1449
Bank Swift Code : MBBEMYKL

ORGANIZER
Hospital Raja Permaisuri Bainun, Ipoh, Perak
Hospital Sungai Buloh (Co-Organizer)
secretariat.ooc2018@gmail.com

MALAYSIAN SOCIETY OF OPHTHALMOLOGY
Room 5, Bangunan Secita, 4A Jalan SS 5D/6, Kelana Jaya
47301 Petaling Jaya, Selangor, Malaysia.
GST Number : 00040217808
VERIFICATION