Online Registration
Personal Details
	Title	:	Prof     Dr     Mr     Mrs     Ms
	Given name	:
	Family name	:
	I/C or Passport No	:
	Preferred name on badge	:
	Affiliated organisation	:
Contact Information
	Mailing address	:
	Postal code	:
	City	:
	Country	:
	Telephone	:
	Mobile	:
	Fax	:
	E-mail	:
Other Details
	SMA member please enter membership number:	:
	Dietary requirements	:

Payment Details
Main Conference	Early Bird Registration	Normal Registration (From 1st September)	On-site Registration
Doctors (Local)	S   $400.00	S   $500.00	S   $600.00
Doctors (Foreign)	US $400.00	US $500.00	US $600.00
Residents & Trainees (Local)	S   $300.00	S   $400.00	S   $500.00
Residents & Trainees (Foreign)	US $300.00	US $400.00	US $500.00
Allied healthcare professionals (Local)	S   $300.00	S   $400.00	S   $500.00
Allied healthcare professionals (Foreign)	US $300.00	US $400.00	US $500.00
Workshop on 29th Nov 2008 (Saturday)
WS2, Advanced Implant Reconstructive Dentistry in the Aesthetic Zone			S   $150.00
WS4, Andrology Workshop – Certificate Course in Medical and Surgical Andrology			S   $150.00
WS5, Faecal Incontinence Workshop			S   $150.00
Not attending any workshop on 29th Nov 2008			S       $0.00
Workshop on 30th Nov 2008 (Sunday)
WS6, Semenology Workshop			S   $150.00
WS8, Sexual Counseling Workshop			S   $150.00
WS9, Urodynamics Workshop			S   $150.00
Not attending any workshop on 30th Nov 2008			S       $0.00
Public Forum on 29th Nov 2008 (Saturday)
Supplementation and Health			S       $5.00
My payment to be made through: Cheque Credit card