Webinar on 5 Dec 2020 (Sat)_Golden Opportunity or Potential Crisis? Being a Speech Therapist in Residential Care Homes for the Elderly

Section 1 - Personal Information
Title *

Title Professor Dr. Mr. Ms.
Surname (in English and Capital Letters) *

The name will be shown on the attendance certificate
Given Name(s) (in English) *

The name will be shown on the attendance certificate
Profession *

Profession Speech Therapist Others (Please specify) Others (Please specify)
Organization / Institution *
E-mail Address *
Contact Phone Number *
Section 2: Payment (Registration Fee: HK$700)
Type of Credit Card *

Type of Credit Card Visa Master
Name of Credit Card Holder
(exactly the same as shown on your credit card) *
Credit Card No. (xxxx-xxxx-xxxx-xxxx) *

Please input "-" after every 4 digits
Expiry Date of Credit Card (MM/YYYY) *

Please input "/" after MM, before YYYY.
The expiry date of your credit card should be after November 2020.
Name of the Person or Organization shown on the payment receipt *

The receipts will be sent to you by post upon the completion of webinar.
Section 3 - Personal Information Collection Statement

The Department will use the personal data provided by you for the Seminar. If you want to have access to or change your personal data, please contact Division of Speech Therapy by email: speechtherapy@ent.cuhk.edu.hk. Besides, please indicate your choice below:
Declaration *

Declaration I would like to receive emails of future events (e.g. symposium, workshops, courses, etc.) from the Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong. I do NOT want to receive emails of future events from the Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong.
Section 4 - Payment Policy

1. Full payment must be received with the completed registration form
2. This event is NOT REFUNDABLE
3. Should the event have to be cancelled due to unforeseeable circumstances, the organizer will try to reschedule the event whenever possible. NO REFUND if you are not able to attend the rescheduled event.
4. If, for reasons beyond the control of the organizer, registration fees will be refunded after deduction of administrative expenses already incurred or 15% of the respective registration fee, whichever is less.
Declaration *

Declaration I declare that I have read and understood all terms of payment policy and I agree to abide by it.
Section 5 - Enquiry

Mr. Edmond Suen (Tel: 3943 9613)
Email: speechtherapy@ent.cuhk.edu.hk
Address: Division of Speech Therapy,
Room 303-304, 3/F,
Academic Building No.2,
The Chinese University of Hong Kong
Disclaimer The personal data collected will be used by Dept of Otorhinolaryngology, Head and Neck Surgery_ENT-ST Division - MED (OHNS_ENT_MED) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.

Webinar on 5 Dec 2020 (Sat)_Golden Opportunity or Potential Crisis? Being a Speech Therapist in Residential Care Homes for the Elderly

Section 1 - Personal Information

Section 2: Payment (Registration Fee: HK$700)

Section 3 - Personal Information Collection Statement

Section 4 - Payment Policy

Section 5 - Enquiry Mr. Edmond Suen (Tel: 3943 9613) Email: speechtherapy@ent.cuhk.edu.hk Address: Division of Speech Therapy, Room 303-304, 3/F, Academic Building No.2, The Chinese University of Hong Kong

Section 5 - Enquiry

Mr. Edmond Suen (Tel: 3943 9613)
Email: speechtherapy@ent.cuhk.edu.hk
Address: Division of Speech Therapy,
Room 303-304, 3/F,
Academic Building No.2,
The Chinese University of Hong Kong