Delegate Details
* Mandatory field
Title: * Prof     Dr     Mr     Mrs     Ms    
Full Name: *
Affiliated Organisation / Institution : *
Address : *
 
State : *
Country : *
Postal Code : *
Tel : *
Mobile :
Fax : *
E-mail : *
Are you vegetarian? *  Yes   No
Do you want to attend the Congress Banquet on 4th Dec 2010 *  Yes   No
Maximum seats for the Congress Banquet are 300 only and these seats will be allocated on first-come first-served basis. Tickets will be issued from the Registartion Counter on the registration day based on reservation.
 

Registration Fee
Category Early Bird Registration
On or before 1st Sept 2010		 After
1st Sept 2010
International Delegates
RM 1500
RM 1800
Malaysian Delegates
RM 1000
RM 1200
International Trainees /
Paramedics / Allied Health
RM 1200
RM 1300
Malaysian Trainees /
Paramedics / Allied Health
RM 750
RM 900
* MEMS Member
RM 750
RM 900
Accompanying Person(s)
RM 680 per Person
RM 900 per person
Accompanying Person Details
* MEMS Member - Must be a fully-paid member for at least 2 years before year 2010.

Pre-Congress Workshops
Workshops Date Registration
AACE/MEMS Advanced Course
in Endocrinology (Adult)
1st Dec 2010
Yes(RM 500) No
AACE/MEMS Advanced Course
in Endocrinology (Paediatric)
2nd Dec 2010
Yes(RM 500) No
Thyroid Ultrasound and FNAC
2nd Dec 2010
Yes(RM 500) No
* Space is limited on a first-come first-served basis
 

Payment
My total payment of RM to be made through:
Master or Visa card:
I have authorised the 14th Asia-Oceania Congress of Endocrinology to debit the total amount of RM  from my credit card for the settlement of the above mentioned fees.
Name of Card Holder:
Card Number: - - -
Expiry Date: -
Card Issuing Bank:
CBC Code (The last three digits on the reverse side of your card)
AMEX card:
I have authorised the 14th Asia-Oceania Congress of Endocrinology to debit the total amount of RM
  from my credit card for the settlement of the above mentioned fees.
Name of Card Holder:
Card Number: - -
Expiry Date: -
Card Issuing Bank:
CBC Code (The four digit number on the left/right side of the card)
Company Cheque ( for Malaysians only ) *
Cheque Number:
Cheque Issuing Bank:
Date of Transaction:
Local Order ( for Malaysian only ) *
Local Order Reference No :
TelegraphicTransfer ( T.T. ) *
T.T. Reference No:
T.T. Bank:
Date of Transaction:

 

Please Telegraphic Transfer (T.T) to the following:
Account Name : AOCE 2010
Account No : 514 3567 26852
Bank Name : Malayan Banking Berhad
Bank Address : Wisma Genting Branch
Jalan Sultan Ismail,
Kuala Lumpur
Bank Tel : +603 2163 5051
SWIFT code : MBBEMYKL

 
 

Terms and Conditions
  •

All registration fees will be charged in RM. Payment can be made by credit card, telegraphic transfer or local cheque (Malaysian only).
  •

* Please fax the Local Order/TT slip/proof to the Secretariat
  •

Please note that all related bank charges, financial charges or credit card commission (5%) are to be borne
by the delegates and are not to be deducted from the fees payable to the Congress.
Confirmation
 

- Registration will only be confirmed upon receipt of FULL PAYMENT.
- Upon received the payment, Secretariat will send you a confirmation letter via email.
- Please bring along the confirmation letter and present it upon the Registration

Cancellation Policy
  •

Cancellation of registration must be made in writing to the Congress Secretariat. Refunds will only be made
after the Congress.
- Cancellation received on or before1st October 2010:   100% refund (minus an admistration fee of RM200)
- Cancellation received between 2nd October 2010 and 31st October 2010 : 50% refund
- Cancellation received on or after 1st November 2010 : No refund

* Paid registration fee is not refundable after the stipulated dates for whatever reasons, including failure of obtaining visa.
I fully understand and agree to all the terms and conditions
 
   
 
 

Congress Secretariat: Console Communications Sdn Bhd
Suite 11.8, Level 11, Wisma UOA II, 21 Jalan Pinang, 50450 Kuala Lumpur, MALAYSIA
Tel: +603 2162 0566 Fax: +603 2161 6560 Email: aoce2010@console.com.my