OOTR 5th Annual Conference
Registration Form
February 20-21, 2009
Fisherman's wharf
Macau
 
Please fill out this form and click "confirm" to proceed.

* Required
   
 
First Name: *
Middle Name(s):
Family Name: *
Title: * Prof. Dr. Mr. Ms. Others ( )
Position: *
Department and Institution: *
Mailing Address: *

City: State:  
Country: * Zip Code:
  
Tel: *
Fax:
E-mail: *
Research interest: *
 
Accompanying Person(s)
 
First Name:

Middle Initial:

Family Name:
Mr. Ms
Mr. Ms
Mr. Ms
 
Registration Fee ** (please check appropriate box(es))
 
With Gala Dinner
Domestic
Foreign
Without Gala Dinner
Domestic
Foreign
Early Registration
(on/before Dec 22, 2008)
HK$1,550
USD 200

HK$1,300
USD 170
Regular Registration
(on/after Dec 23, 2008)
HK$1,850
USD 230
HK$1,600
USD 200
Students/Trainee
HK$ 900
USD  110
HK$ 650
USD  80
Accompany person(s)
HK$ 250
USD   30
persons (Total: $ )
 
Methods of Payment ** (check either one of the 2 boxes)

Bank Transfer to
Name of Bank: The Hongkong and Shanghai Banking Corporation Limited
Account Name: Organisation for Oncology and Translational Research Limited
Account Number: 083-468215-838
SWIFT code: HSBCHKHHHKH
Payment Detail: 5th OOTR Conference (Name of participant)
Cheque / Money Order
**Accepted in USD and HK$ only.