SLEEP SUMMIT 2020 DELEGATE REGISTRATION FORM
Welcome respected delegates, we are pleased to know of your interest to be a part of our SLEEP SUMMIT 2020. The meeting will be held in Royale Chulan Hotel Kuala Lumpur, Jalan Conlay Kuala Lumpur from 27 February - 1 March 2020. You may refer to the attached table for the registration rates.

Participants are Eligible for:

Awarded by Malaysia Dental Council (MDC)
 8 CPD Points   (Main Conference)
 10 CPD Points (MFT Workshop)


Awarded by Malaysian Medical Association (MMA)
 20 points (Main Conference)
 4 points   (SomnoMed Workshop)
 10 points (MFT Workshop)


***Early Bird Rate: Register AND pay by 14 February 2020***

NOTE:
1) All rates are inclusive of 3-days full admission to the conference, with daily lunch and coffee breaks.
2) Accommodation is NOT inclusive.
3) On-site registration is NOT available.
4) Limited Seats, registration will be on FIRST COME FIRST SERVE BASIS UPON RECEIVING PAYMENT.


***** Please kindly take note that the conference is limited to 100 pax and workshops are limited to 50 pax.
Once we have reached these numbers, delegates will no longer be able to avail the early bird rates and will be subjected to the normal rates.*****


For MY Delegates, we accept payment via online transfer or via cash/cheque deposit machine.

For International Delegates, we accept payment via telegraphic transfer.

PAYEE / ACCOUNT NAME: PRINCE COURT MEDICAL CENTRE SDN BHD

ACCOUNT NO: 98872000425416 (Please SELECT IBG: NORMAL TRANSFER)
BANK: CIMB BANK          
SWIFT CODE: CIBBMYKL

Please fill in the form below and provide the proof of payment to leewun.chee@princecourt.com
 (attn to Ms. Chee Lee Wun) in order for your registration to be confirmed.

We look forward to seeing you there!
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I would like to attend *
Full Name & Title (this will be inserted in your e-cert) *
Name to be printed on tag *
Delegate's Specialty *
Organisation/Hospital (please include state for MY Delegates & country for International Delegates) *
IC Number for CME Points (or MY Delegates only, for International Delegates you may fill passport number) *
Mobile Number *
Email Address (please provide a working email address as we will be sending your e-cert to this) *
I have made payment via *
TRANSACTION REF NO. (Fill up & Email proof of payment to leewun.chee@princecourt.com) *
Meal Preference *
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