Registration Form
Please register me : Exhibition Visitor Conference
Name : Designation :
Company Name : Gender : Male Female
Address 1 : Tel :
Address 2 : Fax :
City : Mobile :
State : Email :
Post Code : Remark :
Country :    
* Free entrance to exhibition.
Conference
I would like to attend: Total Amount: RM: + GST @ 0% = RM:
APHM - 31 July
APHM - 1 August
APHM - 2 August
Nursing - 27 July



I am Member of
APHM
Non-member
Foreign Delegate
Payment Method

Cheque Payment to "Association of Private Hospitals of Malaysia"
Bank-in slip to:
  Company : Association of Private Hospitals Malaysia
  Bank Account No : 8001129885
  Bank Address : CIMB Bank
Cawangan Jalan Tuanku Abdul Rahman
338, Bangunan Commerce Life
50100 Kuala Lumpur
  Bank Swift Code : CIBBMYKL
Do you give consent for APHM to provide your contact info to the participating exhibitors? Yes No