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Prefix
Full Name (as per NRIC / Passport, applies for E-Cert)
NRIC (Malaysian Delegates Only, for MMA CPD Points)
Preferred Name on Badge
Profession
Profession (if Others)
Place of Practice
Address
Postal / Zip Code
City
State (M’sian Delegates only)
Country
Country Code
Mobile Number
Email
Food Preference
*All congress meals are Halal
Food Allergies (if any)
RSVP for Gala Dinner (Saturday, 23 November 2024)
Yes I confirm my attendence
No I am not able to attend
Error Messages
I hereby declare that the information provided is true and correct.
I acknowledge that I have read and agree to abide by the
Terms & Conditions, Privacy Policy, and Refund Policy of this Congress.
Proceed to Payment
ACTSA 2024
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