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REGISTRATION FORM
DELEGATE’S INFORMATION
(Information will be used for Badge and Certificate Printing)
Salutation
(Required)
Prof
A/Prof
Dr
Mr
Mrs
Mdm
Ms
Profession
(Required)
Doctor
Nurses / Allied Health
Students (Medical / Nursing)
Other
Name
(Required)
First
Last
Designation
(Required)
Institution & Dept
(Required)
Mailing Address
(Required)
MCR No/ SNB Reg No
(Required)
Email
(Required)
Contact Number
REGISTRATION FEES
(Please tick accordingly)
Category
Full Congress Excluding Workshop
Students (Medical / Nursing)
S$150
Nurses / Allied Health
S$250
Members (SPS / PSS / CPCHS)
S$300
Non-Members
S$350
Category
Pre
-
Conference
Workshop
Members (SPS / PSS / CPCHS)
$150
Non-Members
$200
Attend:
(Required)
Full Congress Excluding Workshop
Pre - Conference Workshop
Registration (Full Congress Excluding Workshop):
(Required)
Members
Non-Members
Nurses / Allied Health
Students (Medical / Nursing)
Students (Medical / Nursing)
Price:
Nurses / Allied Health
Price:
Members (SPS / PSS / CPCHS)
Price:
Non-Members
Price:
Registration (Pre - Conference Workshop):
(Required)
Members
Non-Members
Members (SPS / PSS / CPCHS) | Pre - Conference Workshop
Price:
Non-Members | Pre - Conference Workshop
Price:
Total
Mode of Payment
(Required)
CHEQUE / BANK DRAFT
BANK / TELEGRAPHIC TRANSFER
INVOICE
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)
Co./Institution: Department: Mailing Address (invoice) Contact Person: Contact No: Email (invoice):
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
1 June 2023
. The organising committee regrets that requests received after this date will not be entertained.
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