9th International Diabetes Federation Western Pacific Region Congress

9th International Diabetes Federation Western Pacific Region Congress
 
HKODA would like to sponsor one member of HKODA to attend "9th International Diabetes Federation Western Pacific Region Congress" on 24th to 27th November 2012, in Kyoto, Japan. Our sponsorship will cover Registration fee, Air ticket and Accommodation during meeting period for the nominated delegate. Interested applicant please fill in the application form below and fax to 3747 9862 or Email to “momokoyu@yahoo.com.hk”, Exco of HKODA.
 
Application form for Sponsorship of  “9th International Diabetes Federation Western Pacific Region Congress" November 24th - 27th, 2012, in Kyoto, Japan.
 
Name:
 
Membership Number :     ______
 
1. Sponsored through HKODA with last  
 36 months  ○
 24 months  ○
 12 months  ○
 Never      ○
 
2. Active contribution in the association. If yes, please specify 
 
3. Specialty professional qualification ____________________________________

4. Experience relevant to criteria. If yes, please specify
 
5. Academic presentation at the conference. If yes, please specify
 
Deadline: 17th August 2012


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