Conference Registration Form Mi-PHARM 2024

Conference Registration

Please book for your conference by filling the form below.
Full Name*

First NameLast Name
E-mail*
example@example.com
Designation*
Position
Institutions
Research area/interest
Phone Number*
Billing address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Participant category

Abstract and Presentation details
Would you like to submit an abstract: if yes, please proceed to fill in the form below.*

YesNo
Presentation mode:

Poster presentationOral presentation
Abstract title:
First author:
First author affiliation:
Corresponding author:
Corresponding author affiliation:
Please upload your abstract here. (Refer to the abstract template provided on our website)

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Payment Details
Are you interested in our pre-conference workshop?

YesNo
Total amount:
Please follow the link below to proceed for payment:

https://mahsa.edu.my/epay/online-payment.php

Provide following details:

Programme Name/Course Name: Others
Please Specify Other Programme: Your full name
Proof of payment:*

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Should be Empty: