Fill in the form provided and sent your registration fee along with this form as soon as possible to book your place. As the seat and the hotel accommodation is limited, please sent your registration as soon as possible on or before 8 th August 2009
Name:.................................................................................
Accompanying person (name)......................................................
Full Postal Address:....................................................................
.........................................................................................
.........................................................................................
.........................................................................................
Tel. Office.............................Res:........................................
Mobile:...............................................................................
E mail:...........................................................................
Interest:........................................................................
Registration before 8th August 2009
Delegates US $ 250.00 ( sharing room)
Accompanying person: US$ 200.00 ( sharing room)
Single Occupancy Room: US$ 350.00
( Room for 3 days 2 nights )
Conference Only: US 150.00 ( no accommodation)
After 8 August
delegates US$ 300.00
Accompanying person: 180.00
Single Occupancy Room: $ 400.00
The payment includes: Conference fee, 3 days 2 nights Hotel accommodation.
Conference bag, Papers & Booklet will be provided.
Kindly pay as soon as possible or before 8th August 2009
Mode of Payment:
Direct telegraphic transfer t.t. or Bank Draft in favor of
Institut Penyelidikan Perubatan Akupunktur
Name of Bank: OCBC Bank, Kuala Lumpur, Malaysia
Account No: 755 104 27 85
Bank Swift Code: OCBCMYKLXXX
For fast and easy payment, kindly pay through Western Union Money Transfer in favor of
Dr Nik Omar bin Nik Daud
Please sent your payment slip / Bank Draft / Western Union Code Number direct to:
Secretariat ICHC 2009
Att: Prof Dr Nik Omar
The Faculty of Homeopathy Malaysia
No.122 Taman University, Kg Gelang Mas, Meranti,
17010 Pasir Mas, Kelantan, Malaysia.
For making your registration, you can also contact the national Vice President of your country
OR
Secretary Adminstration, Dr.Sandeep Kaila at asianhml@gmail.com
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