10x10 International Course on Health Informatics Online Registration Form (22 January 2024 Run)
Distance-Learning with Live, Online Tutorials
http://www.gatewaypl.com/g2hi
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Name of Participant: *
Title: *
Email address: *
Telephone contact: *
Please indicate *
Please indicate: *
Billing Person's Name: *
Billing Address: *
Postal Code *
Participant's Organization *
Participant's Job Designation: *
NRIC / FIN No. (last 3 digits + alphabet eg xxxx365B)
Date of Birth - dd/mm/YYYY  *
Course Fee:
- Course fee is SGD $2,000 net (no GST) for all (Singapore and non-Singapore) participants
- Singapore citizens who are self-sponsored are eligible to use Skill Future Credits (subject to confirmation)
- NTUC union members are eligible for UTAP support.

Details: www.gatewaypl.com/g2hi 
Closing Date for Registration
Registration closes 1 week before Course Start Date
Terms:
Any cancellation or replacement must be conveyed to the Course Administrator, Gateway Consulting, in writing. A cancellation charge of 10% of course fee will be levied if cancellation is received after Registration Closing Date and before Course Start Date.  There will be no refund if the cancellation is received on or after Course Start Date.  The organizer reserves the right to modify the Course program without prior notice or cancel the Course, with full refund to participants who had fully paid the Course fees, should unforeseen circumstances necessitate the cancellation of the Course.

By completing this form, you have consented and agreed to the collection, use and disclosure of your personal data for marketing, as well as administrative & business operations of Gateway Consulting Pte Ltd.
Enquiries:
The Course Administrator,
Gateway Consulting,
#03-02 AZ Building, 140 Paya Lebar Road
Singapore 409015 
Tel: (65) 8012 0405 / 8121 9898
Email: admin@gatewaypl.com
Payment:
- Bank transfer to UOB Account: 347-300-634-9
- PAYNOW to UEN 200615816N
- Cheque payment  to “Gateway Consulting Pte Ltd”.    

For other forms of payment, please contact the Course Administrator - admin@gatewaypl.com
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