Registration Form (Category Ⅱ)

  Download: PDF / DOC

The completed registration form should be submitted by either of the following methods:

  1. E-submission (complete and transfer in the conference website)
  2. Email (inq05@iscm.org.mo) or Fax (853-753 362) to
    International Society for Chinese Medicine (ISCM)
Personal particulars

Name & Title :

(English)

 

(Chinese, if applicable)

Organization:

Department/Unit:

Position:

Contact Address:

Telephone:

Fax:

E-mail address:

Do you plan to submit a paper?

Yes,please complete the abstract submission form
 
No
 

 

 

Registration Fee

Category

On or before 15 Feb, 2005
(MOP)

After 15 Feb, 2005
(MOP)

Your participation

Conference (1-3 April, 2005)
Chinese Medicine for the Prevention and Treatment of Contemporary Diseases: An Evidence-based Approach

$ 2,000

$ 3,000

Symposium (31 March, 2005)
Enhancing the “Evidence” of Evidence-based Chinese Medicine

$ 800

$ 1,000

Conference + Symposium

$ 2,500

$ 3,600

Your Registration Payment : MOP

 

Methods of Payment (Payment can be made by one of the following methods)

1. Visa/MasterCard credit cards

Please fax/mail this form with cardholder's signature to the secretariat ( mailing address in Mailing Information below)

Please note that credit card payment is NOT acceptable with on site registration

2. Bank Draft payable to

Please make the Bank Draft payable to " 2005 ISCM International Conference on Chinese Medicine " with all bank charges to be born by the remitter

3. Telegraphic/Bank Transfer payable to

Bank name: Banco Nacional Ultramarino Account number: 9004002509
Account name: 2005 ISCM International Conference on Chinese Medicine

Bank address: Banco Nacional Ultramarino, S.A. - Av. Almeida Ribeiro, 22, Macau

Please make all bank charges to be born by the remitter

4. Cash

Only acceptable with on site registration

 

2. Bank Draft payable to

Please enclose the Bank Draft with this registration form to the secretariat (mailing address in Mailing Information below). Personal cheques are NOT acceptable.
Bank name:
Bank draft no. :

 

3. Telegraphic/Bank Transfer payable to

Please enclose a copy of the bank remittance receipt with this registration form to the secretariat (mailing address in Mailing Information below).

Total: MOP (enter amount) on date

by bank transfer via the bank of

 

4. Mailing Information

Secretariat

International Society for Chinese Medicine
Alameda Dr. Carlos D' Assumpcao, no. 335 – 341,
Centro Hotline, 11 andar V, Macao SAR, China
Fa x: +853 753362
E-mail: inq05@iscm.org.mo

Please register only one person per form.

Please send the registration form with a copy of your bank remittance receipt to avoid possible problems.

Only completed forms ( with payment information ) sent before 15 th Feb. 2005 will be charged as early bird