ONLINE REGISTRATION FORM

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FORM NAVIGATION
Please use the Tab key to move to the next field.  All information should be typed in upper and lower case (e.g. King's Road).  Please press the "Submit" button after completion of the Form.  Your registration information and credit card details will be encrypted and securely forwarded to the ASPR 2017 Congress Secretariat.

ASPR 2017 Congress Secretariat
c/o International Conference Consultants Ltd.

Unit C-D, 17/F, Max Share Centre, 373 King's Road, North Point, Hong Kong
Tel: (852) 2559 9973      Fax: (852) 2547 9528       Email: reg@aspr2017.com      Website: www.aspr2017.com

    (A) PERSONAL INFORMATION     * Mandatory fields
 
Title: * Others, please specify:
Family Name: * (in CAPITAL letter)
First Name: *
Position: *
Department: *
Institution: *
Address: *
 
 
City/State:    
Postcode: Country:*
Tel: *
(Country code)(Area code)(Telephone number)
Fax:
(Country code)(Area code)(Telephone number)
Email: *
(Email is required for future communications.)
Special meal requests: Vegetarian Pork-free Beef-free Others (Please specify: )
    (B) REGISTRATION FEES FOR 3-DAY CONGRESS

Category
Early Bird
(on or before
5 August 2017 )

Regular
(between 6 August
and 5 October 2017 )
On-site
(on or after
6 October 2017)
Non-local
HK$2,000
HK$2,400
HK$2,800
Local (Hong Kong)
HK$1,200
HK$1,500
HK$2,000
Trainee / Nurse / Allied Health Professional #
HK$1,200
Full Time Student (Undergraduate / Postgraduate) of Medical, Nursing, Allied Health, Science or related disciplines *
UPLOAD STUDENT PROOF

(File format: jpg, gif, png & pdf; Max. file size 10MB)
HK$100
Complimentary Registration
Local Organizing Committees
Invited Speakers
Chairperson of Symposium
Complimentary (Inclusive of a Gala Dinner Ticket)

50% discount will be offered to the members of the following societies.  Please indicate if you are a member of:

Less: 50% discount at HK$
Total (B)  
HK$  

# Verification letter signed by your Supervisor/Trainer from your institution is required to qualify for the Trainee / Nurse / Allied Health Professional fee.
* Student ID card is required to qualify for the Student fee.


    (C) OPTIONAL FUNCTION

Gala Dinner on 6 October 2017 at HK$500 per ticket. I would like to purchase tickets.
Total (C)
HK$


    (D) LETTER OF INVITATION

On request, the ASPR 2017 Congress Secretariat will send a Letter of Invitation by email to participants to attend the Congress.  Such an invitation is extended specially to assist participants to obtain travel refunds, appropriate visas, approvals, sponsorship or leave.  The letter will be issued only after the payment has been received.  It does not imply a commitment on the part of the Organizer to provide any support, financial or otherwise.     
  Please send me a Letter of Invitation.

    (E) PAYMENT DECLARATION


I hereby agree to be bound by the rules and regulations of the Congress and would like to settle the payment of HK$ by:

 
Credit Card (in Hong Kong Dollars only): Visa or MasterCard

VISA     MasterCard  
(Please contact your credit card company to notify them of this international charge to prevent the transaction from being rejected.  The merchant name shown on the statement will be ICC LTD and the amount charged will be in HKD.)

I hereby authorize International Conference Consultants Ltd. (ICC Ltd.) to debit the above-mentioned amount from my card.

Card Number - - -
Name of Cardholder
Expiry Date / (MM/YY)  
   
Bank Draft in Hong Kong Dollars payable to “Hong Kong College of Paediatricians
   
Personal or Company Cheque in Hong Kong Dollars payable to “Hong Kong College of Paediatricians(for Local Participants only)



Cancellation Policy

Cancellations must be made in writing to the Congress Secretariat and the refund will be made after the Congress.  If cancellation is received on or before 5 August 2017, 50% of the registration fee will be refunded.  There is no refund of registration fee thereafter.
Please note that substitution is permitted on the basis that written notice is received before 18 September 2017.

Rules and Regulations

  1. Registration without payment will NOT be processed.  Please do NOT send cash.
  2. Secretariat will send a letter of confirmation by email upon receipt of your registration and full payment.  Kindly check the letter of confirmation.  Any changes or alterations must be made in writing to the Secretariat.
  3. The programme is subject to change without prior notice.  In the event of cancellation of the Congress, the only liability of the Organizer is to refund all the fees paid.
  4. All enquiries, changes and cancellations should be made in writing to the Secretariat.


I hereby agree to be bound by the rules and regulations of ASPR 2017.