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Title: 20th FAPA Registration Form
Date: 16-Aug-2004
Category: FAPA

How to sign up ?

Registration is still open but the fees is now US400/- and not as stated in the form below. Those still interested to go can register through the MPS.However for the travel package, it will have to be single room only.                                                                         

Fill in the MPS-FAPA REGISTRATION FORM below

  1. Fill in also the 20th Bangkok FAPA Congress Registration form
       You may obtain a copy of this from the MPS website, or you may call us to fax/send you a copy
  2. You may directly register with FAPA >> click here 
  3. Send both forms back to MPS together with your deposit / full payment by 20th September 2004

MPS-FAPA REGISTRATION FORM

Name

       

                                                     

Place of Practice

 

 

Address

 

 

Tel  
Fax  
Email  
MPS Membership No.  

 

Payment enclosed is my cheque no. ...................,for RM..................being the 50%

deposit / full payment, / and another cheque no. ..................for ...................being

the balance 50%.

Or enclosed please find the LPO No.....................for RM................ being in full payment.

Or please bill my credit card as below for the amount of RM..................being the 50% deposit / full payment to be charged immediately / and

the balance of RM........................being the balance 50% to be charged by 30th

September 04  (Please include 4% to the total amount payable)

Amex / Diners / Mastercard / Visa No. ........................................

 

Expiry date:........................Signature ................................

Fees (The FAPA Registrations fees below is for registration before 31st October. The fees now is at USD 400/-)

 

Rate

Total

 

PART 1: FAPA Registration Fees:

                                       See note 7 below (this fees is for FAPA)
     Ordinary Member  RM 1,365     If you go alone
     or Pharmacy School Student  RM    390   If you are a student
     plus Accompanying Person  RM    585   If your spouse is coming along
Part 2: Hotel, Airfare and Basic Package  RM 1,420   Basic package (1 person, twin sharing room)
Plus airport tax, fuel surcharge    RM    256 (Airline & Airport charges)
Plus Extended Package (optional)  RM    250   Add this amount if you want to stay longer
Plus single supplement (optional)  RM    300   Add this amount if you want a single room
Total Amount Payable (Part 1 and 2)  -------------    
For credit card, please add 4% to the total amount payable  ---------    

Note:
  1. Fees quoted below is subject to change without prior notice.
  2. Airline seats and hotel rooms are subject to availability. Package inclusive of Return economy class tickets / Return airport tax / airport transfers / 7 nights hotel accommodation twin sharing basis at 4-star hotel/ Meals as per listed above.
  3. Carrier is Thai Airways Public Co. Ltd 
  4. Dateline for signing up and to receive 50% deposit / full payment is 20th Sep 04. Balance of payment must be received by 30th September.
  5. Purchase order from those in government service is also acceptable and to reach us as soon as possible.  But to confirm your place please give us an undertaking that you will be responsible for the fees by 20th Sep. 
  6. In case of refund, this must be submitted to us by 20th September and only 50% shall be refunded. However transfer of full amount of fees paid to another participant is allowed up to 20th September, less administration fees. There shall be no refund if cancellation is made after that date.
  7. Please note FAPA registration fees dateline is 30th Sept. You may pay direct, or pay to us for collective payment to FAPA.



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