Annual Scientific Meeting
2014
REGISTRATION FORM
PERSONAL PARTICULARS
(*Please tick accordingly)
 Prof
 Dr
 Mr
 Ms*
Family Name: Click here to enter text.
Practice Address:
First Name:Click here to enter text.
Click here to enter text.
Click here to enter text.
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Postal Code:Click here to enter text.
E-mail:Click here to enter text.
Tel: Click here to enter text.
MCR No: Click here to enter text.
(Applicable for local doctors)

Member of SSP

Fellow of AMS

Staff of SingHealth

Member of SACB
Date: Click here to enter text.
Cheques should be made payable to “Singapore Society of Pathology”.
Please Post / Fax / e-mail the Registration Form by Friday, 3rd October 2014.
c/o: Ms Deborah Halim (Secretariat)
Annual Scientific Meeting 2014
Singapore Society of Pathology & The Chapter of Pathologists, Academy of Medicine, Singapore
81 Kim Keat Road, #11-00 NKF Centre, Singapore 328836.
Tel: (65) 6593 7804 (DID)/(65) 6593 7800 (MAIN); Fax: (65) 6593 7860
E-mail: deborah_halim@ams.edu.sg
Url: http://www.ams.edu.sg/chapter/home.aspx?sec_id=8
Registration is Free for SSP Members, Fellows of the Chapter of Pathologists, SACB
Members and employees of SingHealth.
All other registrations:
$25 for medically-qualified registrants; $10 for all other registrants.
Available from: http://singaporesocietypathology.weebly.com/asm-2014.html
Version One
18 September 2014