Kingdom of Saudi Arabia National Guard Health Affairs King Saud bin Abdulaziz University for Health Sciences
Saudi Physical Therapy Conference & Workshops 14 May 2012 (Workshops), Postgraduate Training Center 15-16 May 2011 (Conference), Riyadh Marriott Hotel
Registration Form PLEASE TYPE OR PRINT CLEARLY AS YOU WANT IT TO APPEAR ON YOUR CERTIFICATE OF ATTENDANCE AND RETURN THIS WITH PAYMENT.
TITLE:
Physiotherapist
GENDER:
Male
Student
Others:
Female
First Name
Middle Name
Profession/Specialty
Family Name
Saudi Council Professional No.
Institution
Telephone No. (Including Information Dialing Code)
Mobile No
Fax No.
Email Address
Mailing Address (City with postal code/country)
The deadline for Early Registration: Wednesday, 18 April 2012
CONFERENCE : 15-16 May 2012 Early Registration
Late & On-Site Registration
SPTA Members (present/attach SPTA ID)
SR 300
SR 400
Non-SPTA Members (Physiotherapists)
SR 350
SR 400
Students
SR 200
SR 250
Others (Physicians, Nurses & Technicians, etc.)
SR 400
SR 450
Category
WORKSHOPS : 14 May 2012 Please select one workshop (Limited seats) Workshop 1
Workshop 2
Workshop 3
A Neuro Restorative Approach to Rehabilitation in Children's with Cerebral Palsy
The Global Approach of Manual Osteopath
Management of wrist and elbow disorders
Early Registration: SR 400 Late Registration: SR 500
Early Registration: SR 400 Late Registration: SR 500
Early Registration: SR 400 Late Registration: SR 500
Important Information: 1. Registration is not confirmed until payment is received. 2. Payment is accepted in cash and bank transfer. 3. Deposit registration fee to: Account Name: ESC/Academic Affairs Account No. 01-08-00520891-009-1 IBAN: SA653040-01-08-00520891-009-1 Bank: Arab National Bank Khashmalaan Branch
4. Send payment and registration form or copy of your deposit slip to: Symposia & Conferences Division, Postgraduate Education and Academic Affairs Deanship, NGHA, P.O. Box 22490, Riyadh 11426, Saudi Arabia, Tel. No. +966 1 801-1111 ext. nos. 48459/48461 Fax: +966 1 2520040, Email:
[email protected] 5. Cancellation/Refund Policy: Request for refund must be received one week prior to the conference. Administrative fee of SR50 or 20% of the total registration fee (whichever is greater) will be deducted from all refunds.
Please visit the event’s website: www.isaudiptc.com