18 th AHML & 8 th International Conference
Homeopathy & Complementary Medicine
4th & 5th October 2009 at Kuala Lumpur
Official Registration Form for
18 th & 8th ICHCM Malaysia 2009
Name:.................................................................................
Accompanying person (name)......................................................
Full Postal Address:....................................................................
.........................................................................................
.........................................................................................
.........................................................................................
Tel. Office.............................Res:........................................
Mobile:...............................................................................
E mail:...........................................................................
Interest:........................................................................
Note: You may print and photocopy this form and use as official registration form.
Registration before 8th August 2009
Full Delegates US $ 250.00 ( sharing room)
Accompanying person: US$ 200.00 ( sharing room)
Single Occupancy Room: US$ 350.00
( Room for 3 days 2 nights )
Conference Only: US 150.00 ( no accommodation)
After 8 August 2009
Full delegates US$ 300.00
Accompanying person: 180.00
Single Occupancy Room: $ 400.00
Conference Only : US$ 200.00 ( no accommodation)
The payment including: Conference fee, 3 days 2 nights Hotel accommodation, tea breaks
and lunchs
Conference bag, Papers & Booklet will be provided.
Kindly pay as soon as possible or before 20th July 2009
Mode of Payment by
Direct telegraphic transfer t.t. or Bank Draft in favor of
Institut Penyelidikan Perubatan Akupunktur
Name of Bank: OCBC Bank, Kuala Lumpur, Malaysia
Account No: 755 104 27 85
Bank Swift Code: OCBCMYKLXXX
For fast and easy and safe payment, kindly pay through Western Union Money Transfer in favor of
Dr Nik Omar bin Nik Daud
Please sent your payment slip / Bank Draft / Western Union Code Number direct to:
Secretariat ICHC 2009
Att: Prof Dr Nik Omar or Prof Mohd Nasir
- The Faculty of Homeopathy MalaysiaNo.122 Taman University, Kg Gelang Mas, Meranti,17010 Pasir Mas, Kelantan,
Malaysia.
- Kuala Lumpur HQ: No. 118 -1st floor, Jalan Raja Laut, 50350 Kuala Lumpur, Malaysia
Tel: 019-9401915 or 0199181915
Fax No: 09-797 6942 or 03-4045 6549
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