APHM2021 Nursing Conference

Registration for APHM Nursing Conference 2021

Date: 14 Oct 2021 - Virtual LIVE via Zoom. This conference is HRD Corp SBL Claimable & CPD points available. Please provide all necessary information including each participant's hp and email for registration purposes. Privacy rights apply.

Part 1: Company Info & Contact Person Info
Company Name (for invoicing and registration)*
Company Address
Line 1
Address Line 2
Line 2
Postcode
City/State
Country
Company Phone Number (eg 603 - 123455)

Area CodePhone Number
Is your company a member of APHM?*

YesNoNot sure
Contact Person's Name (HR or Person handling on behalf)*
Please put your own name if you are registering for yourself only
Contact Person's HP (follow this format 60121234567 country + number)
Contact Person's Email*
Please put your email if you are registering for yourself only

Part 2: Participant Info - Please provide complete info to receive QR code for on-site registrations
Please let us know how many pax that you are registering on behalf under same invoice/ same company (see comments below), so that we can extend group discount where applicable and for us to compile for invoicing purpose for all participants under one same company/registration/invoice.*
How many participants that you are registering under same group?
This is pax number ?*
Indicate if this is pax number 01; 02; 03..etc... that you are registering under same company...
Participant Full Name (include Dr/Dato etc)*
No need to indicate for Mr/Miss - only for official titles that goes with your name
Designation*
Email of participant to receive logistic info and Zoom login details*
must be email of the participant and NOT the contact person/HR unless is the same person
Mobile HP of the participant to receive Zoom login details and reminders (follow this format 60121234567 country + number)*
must be HP of the participant and NOT the contact person/HR
Please select which package*

APHM Member (RM400)Non-Member (RM600)
Please advise if this participant requires Zoom orientation session*

YesNoNot sure, will let you know before 30 Sept if needed.Other

Registration for APHM Nursing Conference 2021