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  • Registration Form - 26 July 2023 - Nursing Webinar Session 142023 Perioperative

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    Kamsahamida Kamsa
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    This document is a registration form for a nursing webinar on perioperative care taking place on July 26, 2023. It requests information such as the participant's name, email, phone number, address, occupation, and organization. It also outlines the product being purchased (the webinar), lists the price as RM60, and notes cancellation policies that fees are non-refundable if cancellation occurs within 30 days of the program.

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    This document is a registration form for a nursing webinar on perioperative care taking place on July 26, 2023. It requests information such as the participant's name, email, phone number, address, occupation, and organization. It also outlines the product being purchased (the webinar), lists the price as RM60, and notes cancellation policies that fees are non-refundable if cancellation occurs within 30 days of the program.

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    4 views1 page

    Registration Form - 26 July 2023 - Nursing Webinar Session 142023 Perioperative

    Uploaded by

    Kamsahamida Kamsa
    This document is a registration form for a nursing webinar on perioperative care taking place on July 26, 2023. It requests information such as the participant's name, email, phone number, address, occupation, and organization. It also outlines the product being purchased (the webinar), lists the price as RM60, and notes cancellation policies that fees are non-refundable if cancellation occurs within 30 days of the program.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    REGISTRATION FORM - 26

    JULY 2023 - NURSING


    WEBINAR SESSION 14/2023
    PERIOPERATIVE

    *Registration Notes:

    - Pesanan Kerajaan (LO) tidak dibenarkan ditarik balik


    jika pembatalan tidak dimaklumkan kepada urus setia dalam
    tempoh 7 hari sebelum program.

    **Cancellation and Refund Policies:

    - Fees are not refundable for the cancellation made within 30


    days before the program.

    Attention! Please complete the form.

    * Required fields

    1. PURCHASE DETAILS

    Price
    Product Quantity* (RM)

    NWPERIOPERATIVE (TERBUKA 60.00


    1
    KEPADA PESERTA LUAR - BAGI
    PESERTA PPUM YG INGIN
    MENDAFTAR, SILA RUJUK
    KETUA JABATAN) - RM60.00

    TOTAL 1 60.00

    GRAND TOTAL (RM) 60.00

    2. CLIENT DETAILS

    Name*

    Enter your name...

    Email*

    Enter your email...

    Mobile Number*

    Malaysia (+60)

    Enter your mobile phone number...

    Address*

    Enter your address (line 1)...

    Enter your address (line 2)...

    Enter your address (line 3)...

    Enter your address (line 4)...

    Postcode*

    Enter your postcode...

    City*

    Enter your city...

    State*

    Select your state...

    Country*

    MALAYSIA

    Organization / Institution?

    University of Illinois, Universiti Teknologi Malaysia or KPJ Taw

    Occupation*

    What is your occupation?

    3. PARTICIPANT DETAILS

    NWPERIOPERATIVE (TERBUKA KEPADA PESERTA LUAR


    - BAGI PESERTA PPUM YG INGIN MENDAFTAR, SILA
    RUJUK KETUA JABATAN) - RM60.00

    Participant #1

    Tick if same as the client's details

    Name*

    Enter participant's name...

    Email*

    Enter participant's email...

    Mobile Number*

    Malaysia (+60)

    Enter participant's mobile phone number...

    Next !

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