5th APSIC Training Course
in Infection Control
12 – 22 July 2010
Grand Copthorne Waterfront Hotel , Singapore

REGISTRATION FORM

Delegate’s Information (Information will be used for Badge and Certificate Printing)

Salutation *

Name *
(Please print in CAPITALS and underline your Family/Last Name)
MCR/NRIC No (For Singapore Registered Doctors / Nurses Only)
Institution/Dept *
Country *
Mailing Address *
 
Contact No. * + Fax No. +
Email *
Alternative Email
Do you wish to participate in the hospital visit on 17 July 2010?

Registration Fees (Please tick accordingly) *
  • For Infection Control Association (Singapore)[(ICA(S)] Members
Category
Normal Registration
On or After 1st March 2010

Nurses and Paramedical

Doctors and Administrators

S$1000


  • For Non ICA(S) Members
Category
Normal Registration
On or After 1st March 2010

Nurses and Paramedical

Doctors and Administrators

S$1250

Payment of Registration

Please mail your cheque/bank draft, in Singapore Dollars and
made payable to Infection Control Association (Singapore), to
our Conference Secretariat. Please indicate the delegate’s name on the back of the cheque/bank draft to avoid any delay in
processing your registration.

Cancellation Policy

  1. Request for cancellation/replacement must be made in
    writing to the Conference Secretariat, latest by 1st June
    2010    . The organising committee regrets that requests
    received after this date will not be entertained.

  2. Please take note that refunds (less 2% for administrative charges) will be issued after the event.

Conference Secretariat

Wizlink Consulting Pte Ltd
261 Waterloo Street, Waterloo Center #02-21, Singapore 180261
Tel: (65) 6338 0062● Fax: (65) 6338 6061 ● Email: ica@wizlink.com.sg