Registration

Foreign
Participants
Early Bird Registration (until April 15, 2010)
Consultant
Resident
Accompanying Person
USD 300.00
USD 200.00
USD 150.00
Late Registration (April 16 to Sept. 15, 2010)
Consultant
Resident
Accompanying Person
USD 350.00
USD 250.00
USD 150.00
On-site Registration (After Sept. 15, 2010)
Consultant
Resident
Accompanying Person
USD 400.00
USD 300.00
USD 150.00


Please accomplish this form to indicate your interest in attending the IFHNOS World Tour in Manila, Philippines. You will receive a formal registration form in the email response. Confirmation of registration will be sent upon receipt of registration fee payment.

Please tick (prefix): Dr.
Mr.
Mrs.
Ms.
Last Name:
First Name:
Hospital Affiliation:
Mailing Address:
Country:
Telephone Number (please include country and area code):
Email Address:
Special Dietary Requirement: Muslim
Vegetarian
Others
Are you bringing an accompanying person? How many? No
1
2
3
Type of accommodation required: Single
Twin
Smoking
Non-smoking
Number of nights required for accommodation:

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1. The conference registration fee must be paid either by bank draft or telegraphic transfer made out in US$. Payment in other currencies will not be accepted.
2. All bank drafts must be made payable to the: “Philippine Society of Otolaryngology – Head and Neck Surgery Inc.” and mailed together with the completed registration form to the Conference Secretariat.
3. Telegraphic transfers must be sent thru the following bank details (please fax a copy of the transaction receipt with your name indicated to (632) 436- 6581).

Account Name: PSO-HNS IFHNOS
Account Number: Current Account 545-2-54500311-7
Bank: Metrobank San Miguel Ave-Ortigas Branch
Bank Address: G/F, Belvedere Cdmn., Ortigas Center, Pasig City
Swift Code: MBTCPHMM