GHC ‘09
PRE-REGISTRATION
Full name*
Position*
Company*
   
Email address*
Contact no.*
 office
fax
mobile
Address*
    
Postal Code*
Country*
Main Business Activity

I wish to register for*

I am registering under the

Contact person for payment confirmation (if different from above)
Name
    
Telephone
    
Email address
    

Payment Modes


Cheque. Please make cheque payable to Magenta Global Pte Ltd and indicate the name of the delegate(s) at the back of the cheque.

Bank Transfer. Payment by telegraphic transfer in Singapore Dollar must be made payable to:
Magenta Global Pte Ltd
Account No: 651-883761-001, OCBC Bank,
Cecil Street Branch, 105 Cecil Street,
The Octagon, Singapore 069534

(All bank transfers must be marked clearly with the delegate name and event title. Bank Charges are to be deducted from participating company’s own account.)
Credit Card. Please debit my credit card:
 


  Name on Card : 
 

Card No:

 

Security Code:

  Expiry Date: (MM/YY)     
   
   

Reserve your seat today! Please contact us at +65 6391 2552

Contact Us
Magenta Global Pte Ltd
Level 2, Pico Creative Centre
20 Kallang Avenue
Singapore 339411
Tel: + 65 6391 2552
Fax: + +65 6392 3592
Email: register@magenta-global.com.sg

For speaking and program matters, please contact
Email: enquiries@magenta-global.com.sg

For attending and marketing related matters, please contact
Email: marketing1@magenta-global.com.sg

For sponsorships and exhibition matters, please contact
Email: marketing2@magenta-global.com.sg

Organized by:

Magenta Global Pte Ltd

Official Association

IMTA (International Medical Travel Association)