UniPsych 2017

UniPsych Symposium 2017 - Registration Form (Step II)

Thank you for registering for this year's UniPsych Symposium! This is Step 2 of the Registration process and we are thrilled to have you on board! As your preferred choice of talks will be allocated via a first come, first serve basis, please kindly ensure all information is accurate and completed to ensure prompt processing. If you have not received a reply within five (5) working days, do kindly contact us. While we seek to serve you the best we can, please kindly take note that we can also reserve the right to refuse service. As informed prior to your purchase, tickets sold are on non-refundable and non-transferable, however, exceptions may be made strictly on a case by case basis.
Ticket Number*
This number can be found after purchasing your ticket via our event site. It starts with a T
Verification for Society Special pricing (Please submit the following verification details instructed by your society to enjoy the special rate)

Upload a File
Please note that failure to authenticate will result in a refund of your ticket and cancellation of registration. You are recommended to fill in this form on a computer, Cancelof
Name*

First NameLast Name
NRIC / Passport Number*
Matriculation Number*
Email (Please ensure this email is regularly checked)*
example@example.com
Phone Number*

Area CodePhone Number
Institution of Study*

James Cook University SingaporeSingapore Institute of ManagementNanyang Technological UniversityNational University of SingaporeSingapore Management UniversitySingapore University of Social SciencesSingapore University of Technology and DesignSingapore Institute of TechnologyOther
Which year of study*

This is your FIRST choice for speaker allocation

Please kindly ensure that your choices for the FIRST and SECOND choice are not identical to avoid disappointment. Should your first choice be unavailable, we will proceed to your second choice subsequently proceeding towards random allocation. While we seek to give you your desired choice of talks, the organisers reserve the right to allocate you to a session at random if your choice is not available/ readily indicated.
Your 1st choice for the First Session @ 1030-1200hrs*
Your 1st choice for the Second Session @ 1400-1530hrs*
Your 1st choice for the Third Session @ 1545-1715hrs*

This is your SECOND choice for speaker allocation

Please kindly ensure that your choices for the FIRST and SECOND choice are not identical to avoid disappointment. Should your first choice be unavailable, we will do our utmost best to attend to your second choice, subsequently proceeding towards random allocation. While we seek to give you your desired choice of talks, the organisers reserve the right to allocate you to a session at random if your choice is not available/ readily indicated.
Your 2nd choice for the First Session @ 1030-1200hrs*
Your 2nd choice for the Second Session @ 1400-1530hrs*
Your 2nd choice for the Third Session @ 1545-1715hrs*

Transport Arrangements (subject to demand):*
Any Medical Conditions we should be aware of?
Your Dietary Requirements (all our meals will be Halal certified):*

VegetarianNon-vegetarianOther
By submitting this application form, you agree that inPsych may collect, use and disclose your personal data, as provided in this application form, or (if applicable) obtained by our organisation as a result of your membership, for the following purposes in accordance with the Personal Data Protection Act 2012 and our data protection policy (available at our website ):
1. the processing of this membership application; and
2. the administration of the membership with our organisation.
Should be Empty:

UniPsych Symposium 2017 - Registration Form (Step II)

This is your FIRST choice for speaker allocation

This is your SECOND choice for speaker allocation