REGISTRATION FORM

 Medicine 2010
(Raising the Quality of Education & Care)
March 15-18, 2010 (09-10 Rabi Al Awal 1431H)

Please print clearly. Your Name will appear on your "Certificate" exactly as you spelled on this form.
FIRST NAME  
MIDDLE NAME  
LAST NAME  
TITLE: Dr Mr Miss
Name of hospital  
Profession  
Telephone  
Mobile  
Email Address  
     
   
Registration Fees:  
 
Consultants 300 SR.
Residents. Interns, Nurses, Pharmacists 200 SR.
Medical Students 100 SR.
   

Policy:
  1. Registration FEE’s are non transferable and non refundable.
  2. For bank deposit, Original Slip must be submitted to CME Office.
  3. Attendance (signature) is a MUST.
  4. In case of NO Attendance, NO Evaluation or NO Receipt, NO Certificates will be given.
  5. All CERTIFICATES will be distributed at the end of the program on the last day of the activity.
  6. No certificate will be given after the end of the last day of the event.
  7. Unclaimed certificates MAY BE claimed from the designated organizing department a day after the event date.

Mode of Payment:

    
Cash CPE Office, ATA, 2nd Floor, Academic Bldg., King Fahad Medical City
Bank or ATM  King Fahad Medical City, Account No. SA9620000002480333359940 (Riyadh Bank)
 

 For more information's, please contact:
CPE Department @ Tel. No. : 01-288-9999 Ext. 4454/7497/4114
Fax No.: 01-288-9000 Ext. 4114
Email: cme@kfmc.med.sa
Website: www.kfmc.med.sa