*Compulsory

Registration Form

Personal particulars:

Title*:	Select one... Prof. Dr. Mr. Mrs. Ms. Miss This field is required. Please select.
Surname*:	This field is required. Please fill in.
First Name*:	This field is required. Please fill in.
Institution*:	This field is required. Please fill in.
Department:

Postal address:

Address 1*:	This field is required. Please fill in.
Address 2:
Address 3:
Country:

Contact information:

Telephone*:	This field is required. Please fill in.
Mobile:
Fax:
E-Mail*:	This field is required. Please fill in. Please provide valid e-mail.

Registration Fee: 0 Euro*

This field is required. Please select.

Type	Local delegates	Overseas delegates
Trainees/Residents#:	HKD500	50 Euro
Regular (ILCA members):	HKD1500	150 Euro
Regular (non-ILCA member):	HKD2500	250 Euro

^{# An accompanying letter confirming the status from the Supervisor is needed.}

Method of payment:*

This field is required. Please select.

	Bank draft for Euro
	Personal cheque for HK$
	Credit card (Visa or MasterCard only)

Personal Information Collection Statement:

The information you provide will be used to update the online registration database, and will be kept strictly confidential. The Organizer may use such data for administrative and communication purposes, but will not disclose any personal information you provide to any external bodies or organizations unless you have been informed or it is required to do so by law. For the University's policy on personal data, please visit http://www.cuhk.edu.hk/policy/pdo/en/.

* I have read and agreed with the above "Personal Information Collection Statement"

This field is required. Please select.

Registration ID will be sent to the participant by email after completing the on-line registration.

Registration is completed only after we have received payment.
Bank draft / Cheque should be made payable to "The Chinese University of Hong Kong",
please write on the back of the bank draft / cheque your registration ID and name.

Bank draft/ Cheque should be mailed to:

Miss Iris Law
301E, 3/F, Sir YK Pao Centre for Cancer
The Chinese University of Hong Kong
Prince of Wales Hospital, Shatin
Hong Kong SAR, China

If you choose to pay via credit card, please download and fill in the payment form and return it to Miss Iris Law at irislaw@clo.cuhk.edu.hk.

Enquiries:
Email: irislaw@clo.cuhk.edu.hk
Fax: (852) 2648 8842

Cancellation Policy

There will be no refund on cancellation after registration.

The registration is now closed.