37th Singapore-Malaysia Join Meeting in Ophthalmology

Registration Form

REGISTRATION FEES
Categories	Early Bird Rate (By 17 Novemeber 2023)	Standard Rate (17 Novemeber 2023 Onwards)
Ophthalmologist (19 - 21 January 2024)	S$350	S$400
Ophthalmologist (AIOS Member) (19 - 21 January 2024)	S$350	S$400
SNEC-SERI Alumni (19 - 21 January 2024)	S$350
Resident / Trainee / Fellow (19 - 21 January 2024)	S$280	S$330
Resident / Trainee / Fellow (AIOS Member) (19 - 21 January 2024)	S$280	S$330
Nursing & Allied Health Professional (19 - 21 January 2024)	S$280	S$330
Day Rate for Nursing & Allied Health Professional (19 January 2024 only)	S$150	S$200
Trade Delegate (19 - 21 January 2024)	$100	$150
Medical Student (19 - 21 January 2024)	$100	$150
Accompanying Person (19 - 21 January 2024)	$100	$150
Hands-on Imaging Course (19 January 2024)	S$80
Wet Lab Instruction Courses^ (21 January 2024)
a. Basic Phacoemulsification (Phaco) Surgery Course (Fully Subscribed)	S$250
b. Advance Phacoemulsification (Phaco) Surgery Course (Fully Subscribed)	S$250
c. Minimally Invasive Glaucoma Surgery (MIGS) Course	S$250

* To qualify for the Resident/Trainee/Fellow registration rate, a letter of verification from your department head or fellowship sponsor must accompany this registration and be emailed to Sin-Malmeeting2024@eventsthreesixty.com.sg.

Early Bird Registration Promotion: Complimentary Singapore River Cruise on 20 January 2024 to the first 90 Foreign Delegates who complete the registration & payment.

Please fill in all the compulsory fields denoted by *

Category *

Accompany Person *

Yes

Hands-on Imaging Course*

Yes

Wet Lab Instruction Courses

c. Minimally Invasive Glaucoma Surgery (MIGS) Course

DELEGATE'S PARTICULARS

Title *

Year of Birth*

Family/ Last Name *

First Name *

Name on Namebadge* (max 15 characters)

Name on Certificate *

Full Name*

Institution *

Designation / Job Title *

Department *

Country *

Contact No. *

Email *

MCR No.

Dietary Requirements *

Welcome Reception

3. Payment

TOTAL AMOUNT PAYABLE: $0.00

Payment mode *

Cheque / Bank Draft

Telegraphic / Bank Transfer

Credit Card

Cheque / Bank Draft No.

• All cheques / bank drafts should be made payable to "Society of Ophthalmology of the Singapore Medical Association".

• Please indicate your Name and Contact Number clearly and that the payment is meant for "37th Sin-Mal Meeting" at the back of the cheque / bank draft.

• Kindly mail cheque / bank draft to "37th Sin-Mal Meeting Secretariat, c/o Events.360 Pte Ltd, 2 Jalan Rajah #05-20, Singapore 329134".

Telegraphic Transfer Reference No.

Bank / Telegraphic Transfer

Account Name	: Society of Ophthalmology of the Singapore Medical Association
Account No.	: 067-000677-1
Bank Name	: DBS Bank Ltd
Bank Address	: 12 Marina Boulevard, DBS Asia Central, Marina Bay Financial Centre Tower 3, Singapore 018982
Swift Code	: DBSSSGSG
Bank Code	: 7171
Branch Code	: 067

• Please note that all bank charges are borne by remitter (ordering customer).
• Please state on the remittance advice that the payment is for "37th Sin-Mal Meeting" and indicate your Name and Contact Number clearly.
• Upon completion of the transfer, please email a copy of your remittance advice with your Name to the Secretariat at Sin-Malmeeting2024@eventsthreesixty.com.sg for tracking purposes.