Registration - Self Paying Delegate

Self-Paying Delegate

Specialty (Choose 1 only)

Prefix

Full Name (as per NRIC/ Passport)

Family Name / Surname

Place of Practice

Address

Postal / Zip Code

State / Province

City

Country

Mobile Number

Phone Number

Fax Number

Name to appear on e-certificate

NRIC (for Malaysia CPD Points)

Seminar Fee

Basic Scientist / Allied Healthcare - RM 790

MEMS Member / Trainee* - RM 890

Medical Professional - RM 990

AFES Trainee** - USD 300

International Delegate - USD 400

* Fee stated above excludes Government taxes, levies or charges. Any taxes, levies or charges which may be introduced & subjected in accordance with Malaysian Government Legislation will be additional to the prices quoted.

** Self paying rates.

Payment Receipt

Upload File

I hereby declare that the information provided is true and correct.

Thank you for your registration!
You are now on the Waiting List. Upon verification of your payment & space availability, an email with all the Event Attendance information will be sent to your registered email.

If you have any questions, please contact:
secretariat@memsmac.org

Payment for MAC 12 MEMS 2022 is to be made to:

Bank Details

Account Name :

Malaysian Endocrine & Metabolic Society

Account No. :

80-0050502-9

Bank Name :

CIMB Bank

Bank Address :

No. 64, Wisma Jayanita, Jalan Raja Muda Abdul Aziz, Kampung Baru, 50300 Kuala Lumpur

Bank Tel. :

+603 - 2694 9303

SWIFT Code :

CIBBMYKL

If you are making payment via telegraphic transfers, bank charges are to be borne by delegate.

Self-Paying Delegate

Thank you for your registration! You are now on the Waiting List. Upon verification of your payment & space availability, an email with all the Event Attendance information will be sent to your registered email. If you have any questions, please contact: secretariat@memsmac.org

Bank Details

Thank you for your registration!
You are now on the Waiting List. Upon verification of your payment & space availability, an email with all the Event Attendance information will be sent to your registered email.

If you have any questions, please contact:
secretariat@memsmac.org