Registration Form

Registration Form

Please fill in the form below:
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Saudi Council Registration ID Number (If Available)
Work Specialty *
Current Employee
Please check the Registration Fees*

Physician 1000 SRNon Physician 500 SROther (Student- technician) 250 SR
Payment Method: Bank transfer.

Bank Name : AlEnma' Bank

Account Number : 68280008880011

IBAN : SA3005000068280008880011

Note:

*Please mention your first and last name on the bank transfer.

*Upon payment, please send complete registration form with a copy of payment confirmation .
Upload Payment Confirmation (JPG or PDF ) Maximum size 1 MB

Browse Files

Cancelof
or send to email below within 24 hours:

VTEawareness2018@gmail.com

Otherwise,The Registration will be Cancelled.

and there is "No Refund” policy.

*The registration will be confirmed upon receiving of payment cofirmation email.

Thank you for Registration
Should be Empty: