Continuous Professional Development Workshop Registration Form

Professional Development Workshop Registration Form

Please fill in the form below.
Event Title
Date

2 November 2019 TIME: 8:00 A.M. - 4:00 P.M
Date

31 October 2019 TIME: 8:00 A.M - 4:00 P.M
Date

23 November 2019 TIME: 8:00 A.M - 4:00 P.M
Personal Information
Full Name *

Prefix First Name Last Name
Job title
SCFHS ID
Specialities *
Nationality
Institute
Registration Date

Day Month Year
Date
Contact Information
Phone Number *

Area Code Phone Number
E-mail *
example@example.com
Confirmed E-mail *
PLEASE CHECK APPROPRIATE REGISTRATION FEE

400SR
PLEASE CHECK APPROPRIATE REGISTRATION FEE

300SR
PLEASE CHECK APPROPRIATE REGISTRATION FEE

300SR
Payment Method: *

Bank transfer. POS (Point of sale) “at simulation & skill development center” (Before one week from course )
Account Number: 68280008880028

IBAN: SA5605000068280008880028.

Account Holder: Simulation & Skills Development center , princess Nourah bin Abdulrahman University, INMA, Riyadh, Saudi Arabia.

SWIFT-CODE: INMASARI.

IBAN: SA5605000068280008880028.

*Please mention your first and last name and "conference/workshop name" on the bank transfer.

*Upon payment, please email complete registration form with a letter of payment confirmation to KAAUH-SC-R@pnu.edu.sa
*

I consent to my name, institution and country to be made available on the future list for courses/ events advertising.
Suggestions or topics you would like to be included in the workshop?
Please email complete Registration Form to "KAAUH-SC-R@pnu.edu.sa"

*The registration will be confirmed upon receiving of payment.

*The Post Graduate courses Calendar here.

*For any help contact with 0118239736.
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Professional Development Workshop Registration Form

Personal Information

Contact Information