Foreign Faculty - Malaysian Orthopaedic Association

RegistrationREGISTRATION FORMI would like to register for the “2nd International Deformity Course and Workshop”.Enclosed is registration form and cheque made payable to “Yayasan Ortopedik”.Payment can also be made through telegram transfer*.Name : ………………………………………. Food / Diet:Hospital : ………………………………………..………………………………………..VegetarianPosition : ………………………………………..E-mail : ………………………………………. Non VegetarianPhone : …………………………………….....Registration fee:Foreign Orthopaedic Surgeon USD 300.00Local Orthopaedic Surgeon RM 500.00Orthopaedic Trainee RM 200.00Paramedics / Nurses RM 100.00Telegram transfer*Bank: Maybank Islamic AccountName: Yayasan OrtopedikAccount Number : 564351504180Swift Code: MBBEMYKLBank address:Ground & Mezzanine Floor, Jalan Sultan Ismail, WismaGenting, 50250 Kuala Lumpur, Wilayah Persekutuan.Please attach proof of remittance with the registration form. (Via mail / fax / email)Secretariat:Attention:Ms Norfazlin2 nd International Deformity Correction Course Tel : 603 7949 3141Department of Orthopaedic Surgery Fax : 603 7949 3141University Malaya Medical CentreEmail: lyn_ryn@yahoo.com50603 Kuala Lumpur,Malaysia