APHM Future Healthcare Conference Registration

APHM Future Healthcare Conference Registration

Once submitted, this will be a valid registration subject to the conference terms. Please read all the T&Cs at https://AFHC25.aphmconferences.com Thank you

Part 1: Company Info & Contact Person Info
Company Name (for invoicing and registration)*
Company Address
Line 1
Address Line 2
Line 2
Postcode
City/State
Country
Company Phone Number (eg 603 - 123455)

COUNTRY+Area CodePhone Number
Is your company a member of the followings:*

AHFAPHMAHF & APHMNon-member
Contact Person's Name (HR or Person handling on behalf)*
Please put your own name if you are registering for yourself only
Contact Person's HP (follow this format 60121234567 country + number)*
Please put your own HP if you are registering for yourself only
Contact Person's Email*
Please put your email if you are registering for yourself only

Part 2: Participant Info
IMPORTANT: Please read this first

We will follow-up with the contact person on the payment and will send the logistic information to each participant's mobile hp and email.

For companies registering more than 1 pax, please submit the form for each pax separately and indicate same company name & contact person name & email. For the 1st form that you fill, complete all the company and contact person info plus full details of pax No.1.

From 2nd pax onwards, you do not need to retype all the company info, only input the company name/contact person name & email and then proceed to complete all the info of the 2nd pax and indicate the pax number under - this is pax number ---?

Eg this is pax number 1, pax number 2....etc

Please email afhc25@aphmconferences.com for any clarification or information.
Please let us know how many pax that you are registering on behalf under same invoice/ same company (see comments below), so that we can extend group discount where applicable and for us to compile for invoicing purpose for all participants under one same company/registration/invoice.*
How many participants that you are registering under same group?
This is pax number ?*
Indicate if this is pax number 01; 02; 03..etc... that you are registering under same company...
Participant Full Name (include Dr/Dato etc)*
No need to indicate for Mr/Miss - only for official titles that goes with your name
Participant Name on BADGE (We will follow this name to print on the participant's name tag/ badge. Please ensure no errors to facilitate on-site registration)*
If need to indicate Dr/Dato on the name, please include them.
Designation*
Please confirm if you are Malaysian citizen or if you are non-Malaysian, please key in your citizenship under Other*

Yes, MalaysianOther
Gender*

MaleFemale
Email of participant to receive logistic info*
Important: must be email of the participant and NOT the contact person/HR unless is the same person.
Mobile HP of the participant to receive reminders (follow this format 60121234567 country + number)*
must be HP of the participant and NOT the contact person/HR
- The fees include attendance and all learning materials for the conference, welcome dinner & conference refreshments.

- The fees DO NOT include hotel guest rooms/ airport pickup/ transportation or optional tours or other f&b expenses.

*Fees in Ringgit Malaysia is HRD Corp Claimable (applicable Malaysian delegates only)
Please select which package*

AHF MembersNon - AHF MembersAPHM MembersNon - APHM MembersLocal Government

Part 3: Payment Information
PLEASE NOTE: All registrations will need to be settled before event's date or write in for any request. Please email afhc25@aphmconferences.com for any clarification. Thank you
Payment Method - please select one*

Direct bank transferHRD Corp ClaimableTelegraphic Transfer (TT)Online paymentOther
If you have selected HRD Corp Claimable as your payment method, please keyin the participant's Malaysian IC No. - as required by HRD Corp grant application
Ex:011111-10-1238
T&C

*Terms: All fees must be paid / All approvals must be received prior to the event’s date. No cancellation allowed within 14 days before the event. However, a substitute from the same organisation is welcome. If no written notice of cancellation is received 14 days prior to event and if the person fails to attend the event, full fees will be chargeable. Any refunds approved may be subject to 25% admin fees. REGISTRATION CLOSES ON 7 FEB 2025.

IMPORTANT NOTES:
- 1-day full conference package is applicable for same attendee and cannot be shared with different attendees. Each attendee must have own registration/package.
- Replacement of attendees must be provided 3 days before events date, failing which we may not be able to amend their names before event. The replacement attendee can still attend under the original name and request for replacement when they come to register onsite. We will identify through the email received for on-site registrations.
- NO UNREGISTERED WALK-INS WILL BE ALLOWED. NO CANCELLATION OR REFUNDS WILL BE PROVIDED.
Any other comments or feedback for us to process this registration
Do you give consent for APHM to provide the participant's contact info to the participating Exhibitors? If you are registering on behalf, please note that your reply represents the pax.*

YesNo
By submitting this form online, you are agreeable to all the terms for this registration as indicated on the website https://AFHC25.aphmconferences.com*

Yes I agree
Date submitted

MonthDayYear
Date
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(c) Copyright 2025. All Rights Reserved. email:afhc25@aphmconferences.com

PDPAct2010 -http://www.eventstraining2u.com/personal-data-protection-act-2010/

The collection of information in this online form is to process conference registrations and the use of the information provided is solely for conference registration processing/ conference logistics and/or as needed by appointed contractors for this Conference. Please email us of any discrepancies or changes to the information provided.
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