2024公衛高峰論壇報名表/ Registration Form of International Public Health Summit 2024
【注意事項】
🔹活動日期：113年5月4日(週六)
🔹活動時間：上午9時至下午5時(臺灣時間)
🔹實體活動場地：醫學綜合大樓(前棟)誠樸廳
🔹報名截止日：113年4月30日(週二)
【主辦單位】
臺北醫學大學公共衛生學院、泰國瑪希敦大學公共衛生學院、臺北醫學大學衛生福利政策研究中心
【備註】
1) 本活動與泰國Mahidol進行雙方連線，將採線上與直播方式辦理，線上會議連結將於報名後提供
2) 實體活動敬備餐點 ，敬請預先報名
3) 本活動以全英文進行
4) 本活動申請公共衛生師繼續教育時數；北醫大教職員工時數；學生學習護照點數
【活動聯絡窗口】
北醫公共衛生學院汪小姐(coph@tmu.edu.tw)
---------------------------English---------------------------
【Notes】
🔹Date: Saturday, May 4th, 2024
🔹Time: 9:00 a.m. to 5:00 p.m.(Taiwan Time)/ 8:00 a.m. to 4:00 p.m. (Thailand Time)
🔹Venue(Physical Forum):
Taiwan:Chen-Pu Conference Hall, Comprehensive Medical Building (Front Building), Xinyi Campus
Tailand: Surin Ostanukroah Room, Building 1, 2nd floor, Faculty of Public Health, Mahidol University
🔹Please sign up for this event before April 30th, 2024
【Hosts】
College of Pubic Health, Taipei Medical University, Taiwan
Faculty of Public Health, Mahidol University, Thailand
TMU Research Center for Health and Welfare Policy
【Remarks】
1) The activity will be conducted both online and as a physical forum. The links will be provided after registration.
2) Refreshments & Meals will be provided for in-person attendees at TMU. Please register in advance.
3) Presentation in English.
4) This event applies for continuing education for public health professionals, staff at Taipei Medical University, and learning points for students.
【Contact Info.】
Ms. Jessie, Taipei Medical University (coph@tmu.edu.tw)
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Email *
姓名/ Full Name *
性別/ Gender *
生日/ Birthday
非必填項目，請填寫西元年( yyyy-mm-dd )
This is an optional field for verification purposes. Please fill in the date in the format YYYY-MM-DD.
MM
/
DD
/
YYYY
國家/ Nation
 *
Example: Taiwan, Thailand....( Please fill in the full name of the country )
身分別/ Identity
 *
教育程度/Educational level
Clear selection
校名/ School
 *
如果你為在學學生或教職員，請填寫所屬校名，若非學生身分者，可填寫畢業學校名稱或目前所屬單位。If you are a student or faculty member, please fill in the school's name you belong to; if you are not a student, please fill in the name of the school you graduated from. (Ex.: Taipei Medical University).
臺北醫學大學所屬系所/ Department at TMU
如果你為北醫在學學生或教職員，請填寫所屬系所，若非學生身分者，可填寫畢業系所名稱。If you are a student or faculty member at TMU, please fill in the department you belong to; if you are not a student, you can fill in the name of the department you graduated from (Ex.: School of Public Health).
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Department at Faulty of Public Health, Mahidol University
If you are a student or faculty member at MU, please fill in the department you belong to; if you are not a student, you can fill in the name of the department you graduated from.
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The departments of other schools
If you are a student or faculty member not from TMU or MU, please fill in the department you belong to; if you are not a student, you can fill in the name of the department you graduated from.
學號/Student ID
報名線上或實體論壇?/ Sign up for online or offline(physical) forum?
 *
本活動與泰國Mahidol進行雙方連線，將採線上與直播方式辦理    The activity will be conducted both online and as a physical forum, in collaboration with Mahidol University in Thailand, with both Thailand and other countries opting for an online format.
餐點偏好/ Diet Peference
報名實體論壇者請選餐/ Please choose the meal if you attend physical forum.
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是否需要申請臺灣公共衛生學會繼續教育積分或北醫教職員繼續教育時數 Taiwan Public Health Association Continuing Education /TMU Faculty and Staff Continuing Education Credits
This item belongs to Taiwan.  Non Taiwan Public Health Association members or Taipei Medical University faculty and staff, please do not fill out.
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