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• Personal Information

 

First Name ::
*
Middle Name ::
Family Name ::
*
Title( for Mailing Address)::
Prof. Dr. Mr. Ms.
Institute / Organization ::
*
Mailing Address ::
Home Office
Address ::
*
Country ::
  *
Telephone (include international code) :
 *
Fax (include international code) :
E-mail :
 *

• Registration (All fees are in Thai Baht)

Registration Type
Rre-Registration Rate
Early registration
Onsite
Delegate
12,000 THB
21,000 THB
Delegate/Pre congress workshop
19,000 THB
28,000 THB
Nurse
10,000 THB
21,000 THB
Nurse/Pre congress workshop
17,000 THB
21,000 THB

Cancellations: 25 % administration charge will be applied for the written cancellations
before July 15, 2012. Cancellation will not be accepted beyond this date

• Other Program


Review Exam Session (ABAARM only)
10,000 THB
Post Conference Workshop
8,500 THB
Review ABAARM+ABAAHP kits(book and CDs)
27,600 THB

• Payment Method



Credit Card

Please note. "Only Personal Credit Cards may be used and no Corporate or Commercial Cards are acceptable"


• Payment Summary
  
Attendee THB:
   
Review Exam Session (ABAARM only) THB:
Post Conference Workshop THB:
Review  ABAARM+ABAAHP kits(book and CDs) THB:
   
Total Amount THB:
 (EX: 12000.00 THB)
   
   

 

 

           
         
 
 
 
 
 
 
 
 

 
 

Office Secretarier
Address: 10th Floor , 253 Asoke Building, 253 Asoke Road (Sukhumvit 21), Bangkok 10110 Thailand
Office: +662 664 1070/+662 664 1071 Fax.+662 664 1069
Email: info@a4mthailand.com

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