REGISTRATION FORM FOR STUART GAN LECTURE & IMMUNOLOGY SATELLITE SYMPOSIUM

REGISTRATION FORM FOR

STUART GAN MEMORIAL LECTURE & SiPPAC – ACIS IMMUNOLOGY SATELLITE SYMPOSIUM

29 July 2023

08h30 – 12h00 hours

PARKROYAL on Beach Road

STUART GAN MEMORIAL LECTURE & SiPPAC - ACIS IMMUNOLOGY SATELLITE SYMPOSIUM

DELEGATE'S INFORMATION
(Information will be used for Badge and Certificate)

Salutation(Required)

Profession(Required)

Name(Required)

First Last

Designation(Required)

Institution & Dept(Required)

Mailing Address(Required)

MCR No/ SNB Reg No(Required)

Country(Required)

Email(Required)

Contact Number

DAY PASS REGISTRATION FEES

(Please tick accordingly)

Category	Day Pass Registration Fees
SPS Members	S$100
Non-SPS Members	S$150

Attend:(Required)

SPS Members

Non-SPS Members

SPS Members

Price:

Non-SPS Members

Price:

Voucher

Total

Mode of Payment(Required)

Cheque or bank draft, in Singapore Dollars, should be crossed and made payable to “Singapore Paediatric Society” and mail it to the following address:
Wizlink Consulting Pte Ltd
Choa Chu Kang Central Post Office,
PO Box 192,
Singapore 916837
Attn: SPS Secretariat
Kindly email a copy of the transaction slip to secretariat@sps.org.sg for verification purpose.

Transfer the payment with bank details as follows:
Bank Account Name: Singapore Paediatric Society
Bank Account Number: 067-000421-3
Name of Beneficiary Bank: DBS
Address of Bank: 12 Marina Boulevard, Level 3 Marina Bay Financial Centre Tower 3, Singapore 018982
Swift Code: DBSSSGSG

Invoice information(Required)

Registration Notes

Your registration will only be confirmed upon receiving your payment. All officiate receipt will be sent to you within 10 working days after receiving your payment.
Cancellation Policy

Request for cancellation/replacement must be made in writing to the Conference Secretariat, latest by 22 July 2023. The organising committee regrets that requests received after this date will not be entertained.

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