Salutation * (eg. Mr, Mrs, Ms)
Full Name *
Identity Card No. * (MyKad) OR (Passport, if non malaysian)
Gender *
Male
Female
Phone Number * (eg: 012-34567890)
Email * (eg: sample@sample.com)
Required for email notice and participant login
Designation * Specify:
Department
Institution *
Sector *
Select Attendee Type *
Delegate
Meal Preferences *
Non Vegetarian
Vegetarian
Registration Fee (MYR)
Payment Method *
Payment Type *
Payment by Individual Payment by Group
Payer's Institution/Company Name *
Upload Payment Slip
  Payment info
All payments are to be made in favour of:
PERSATUAN PEMBANTU PERUBATAN DAN JURURAW

Direct Payment or Telegraphic Transfer (please include all service charges) to:
Bank: CIMB Bank Berhad
Account No.: 86-0405198-5
Beneficiary: Persatuan Pembantu Perubatan Dan Jururaw
Reference: ADMAN ADC 2025
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