pediatric emergency medicine and crit care assembly + winfocus
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7/31/2019 Pediatric Emergency Medicine and Crit Care Assembly + WINFOCUS
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7/31/2019 Pediatric Emergency Medicine and Crit Care Assembly + WINFOCUS
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International Pediatric Emergency and Critical Care Conference17th-19th August 2012
Amari Huahin Thailand
Applicant Information
Name: Last Name:Current Workplace:
Town: County: Postal Code:Phone: E-mail: Fax:Position:
Registration Fee (Please check on the conference you would like to attend.)
Course 1: International Pediatric Emergency and Critical Care ConferenceDate 17
th-18
thAugust Noon
Course 2 :Workshop for Emergency and Critical Care Bedside UltrasoundDate 18
thNoon -19
thAugust Noon
Registration Fee (Please check on the conference you would like to attendEarly Bird(Before 15July)
Pre Registration
Course 1: InternationalPediatric Emergency andCritical Care Conference
3,000 Thai Baht 3,500 Thai Baht
Course 2:Workshop forPediatric Emergency andCritical Care BedsideUltrasoundDetails
5,500 Thai Baht 6,000 Thai Baht
500 Method of Payment Bank Transfer OthersDate of transfer
Payable to:Emergency Unit, Outpatient department King Chulalongkorn Memorial HospitalAccount : 0455230014Bank: Siam Commercial Bank Public Company Limited (SCB)Bank Address: 1873 Praram 4 Road Pathumwan, Pathumwan Bangkok 10330Swift Code: SICOTHBK
Please state the amount of transfer that you paid
* Please scan your payment method and send to [email protected]( slip atm email ) 02 2564617
Signature of Applicant:
mailto:[email protected]:[email protected]:[email protected]