12th Annual Scientific Meeting

Registration Form for 12th Annual Scientific Meeting
Full Name (As per Identity Card)*
Phone Number*

Area CodePhone Number
Email*
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Registration Type*
Place of Work*
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Job Title*
Please upload your valid ID for verification*

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Are you interested to join Lunch Symposium? (Limited to first 100 registered participants only) *For participants who is not attending lunch symposium, other packed meal will be served. .*
Are you interested to join Lunch Symposium? (Limited to first 100 registered participants only) *For participants who is not attending lunch symposium, other packed meal will be served. *
Registration Fee:

- Doctors: $30.00

- Nurses & Allied Health Professionals $20.00
- Medical Student $10.00

Kindly make payment to account below:

Bank Account statement:

For Baiduri:
Account Name: Cardiac Society - Conference
Account Number: 02-01-110-415230
Bank Name: Baiduri Bank
Bank Address: Baiduri Bank Headquarters, 1 Jalan Gadong, Bandar Seri Begawan, BA 1511
Swift Code: BAIDBNBB

For BIBD:
Account Name: Le Voeu Events Company
Account Number: 00-018-01-000854-5
Bank Name: Bank Islam Brunei Darussalam
Bank Address: Bangunan BIBD, Lot 159, Jalan Pemancha, Bandar Seri Begawan, Brunei Darussalam
Swift Code: BIBDBNBB
Kindly upload payment receipt for registration*

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Registration Form for 12th Annual Scientific Meeting