Registration

Full Name (as per NRIC / Passport, ⁠⁠applies for E-Cert)

NRIC (Malaysian Delegates Only, for MMA CPD Points) | Passport Number (International Delegates Only)

Preferred Name on Badge

Profession (if Others)

Place of Practice (Hospital/Institution)

Address

Postal / Zip Code

City

Mobile Number

*All congress meals are Halal

Food Allergies (if any)

RSVP for Gala Dinner (Saturday, 23 November 2024)

Yes I confirm my attendence

No I am not able to attend

Error Messages

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