Registration Form For Professional Course On Good Clinical Practice (GCP) 2021
Venue:
Seminar Room
IJN-UTM Cardiovascular Engineering Centre
Block V 01
School of Biomedical & Health Sciences
Faculty of Engineering
Universiti Teknologi Malaysia (UTM),
81310 Skudai Johor

Date:
30, 31 May - 1 June 2021
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Email *
Registration Application *
Name (As per ID card) *
Tittle/ Designation *
IC Number/ Passport *
Phone Number *
Please start with: 601
Affiliation/ Institution *
Staff/ Matrix Number (For UTM Staf/Student)
Work Address *
Dietary Restrictions *
Method of Payment
1. Cheques:
    Cheques should be crossed and made payable to BENDAHARI UTM

2. Payment direct to account:
    Account Name : Bendahari UTM
    Bank : CIMB Bank Berhad
    Account No. : 800 60 5353 6

3. Jom PAY:
    Biller Code : 2592
    Ref-1 : Debtor's Code
    Ref-2 : Invoice Number

IMPORTANT:

1. All payment should be settled within 14 days from the invoice date.

2. Please notify payment via email to gcp@utm.my and cc to helpdeskbill@utm.my and the invoice number should be quoted in full in the correspondence.

3. All bank charges should be beared by customer and not to be deducted from total amount.
Contact Detail
Email:
gcp@utm.my

WhatsApp (only):
+6011-5858 5038
A copy of your responses will be emailed to the address you provided.
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