Application Form

Registration Form ANHSS 2025

Development of a National Health Insurance: Roles and Functions in supporting Universal health coverage (UHC) in LMIC
Organised by ANHSS
Co organised with the International Training Centre for Casemix and Clinical Coding (ITCC) HCTM, UKM.
14-15th (Tues-Wednesday) Oct 2025
Venue: Faculty of Medicine (FoM), National University of Malaysia (University Kebangsaan Malaysia), Cheras, Kuala Lumpur Malaysia
Category*

Internasional (USD 200)Malaysia (USD 150)
Title*
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Name*

First NameLast Name
Name in Chinese

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Organisation*
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E-mail*
example@example.com

Education:*

Professional Qualifications:

	Professional Qualifications	Awarding Institution/Country	Date of Award
1
2
3

WorkingExperience:

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I declare that the information given in support of this application is accurate and complete, and understand that anymisrepresentation will result in the disqualification of my application for admission.
Payment Information

Account Holder Name : Asia Pacific Network For Health Systems Strengthening Limited
Address : 2/F, School of Public Health Building, 30-32 Ngan Shing Street Prince of Wales Hospital, Shatin, New Territories, Hong Kong
Account Number: 44719019993 (USD SAVINGS A/C)
Bank Name : Standard Chartered Bank (Hong Kong) Limited
Bank Address : Payment Centre, 15/F Standard Chartered Tower388 Kwun Tong Road, Hong Kong
Swift Code: SCBLHKHHXXX

Remarks:
• The registration fee, once paid, is non-refundable or non-transferable.
• Acceptance of application is subject to availability.
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Registration Form ANHSS 2025