Conference Payment Please enable JavaScript in your browser to complete this form. - Step 1 of 2The organiser of the conference, College of Public Health Medicine, Academy of Medicine Malaysia, only accept payment through bank transfer or ePerolehan Kerajaan Malaysia. We do not offer any other payment facilities. Please complete the form and upload your proof of payment. Each participant needs to complete individual payment form using their user registration account. Full Name *Please enter the fullname of the participantNRIC/Passport Number *Please enter the detail of the NRIC/Passport Number The information must be unique, i.e., you cannot submit two payment form with the same NRIC/Passport Number. If you have submitted wrongly and would like to make changes please contact apcph@cphm.my.Email *The email is automatically retrieved from your user registration details and it cannot be change. Each participant needs to complete the payment form using their user registration account. Contact Number *Type of Participants *LocalInternationalCountry of Residence *MalaysiaAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweMode of Payment *Bank TransferePerolehan Kerajaan MalaysiaNama Pusat Tanggungjawab (PTJ) *Name of Bank *Date of Bank Transfer *Please select the date from the Date Picker or enter the date as day/month/yearNumbor Telefon PTJ *Country of the Bank *MalaysiaAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweLPO No.Payment Amount (International) *USD200 (Low- and Lower-Middle Income Countries)USD250 (Upper-Middle- and High-Income Countries)NOTE: Registration and payment are open from 01 February 2024 to 30 June 2024. We will close the registration and payment form 1-8 July 2024 for us to prepare for the 8th APCPH 2024. There will be an on-site registration and payment from 9-11 July 2024 at the fee of USD300.00 Click to get Countries' Income Level based on World Bank data.Instruction for Payment (International Participants) Please transfer the payment amount to: Please transfer the required amount of payment to: Name: College of Public Health Medicine, Account No.: 514123134872 Bank: Maybank SWIFT: MBBEMYKL Please include the following details in the transfer: Participant's Full Name, Passport Number, and the word "APCPH". You need to upload the proof of payment before you complete this form. Payment Amount (Local) *RM600 (AMM Members)RM600 (Students)RM700 (non-AMM Members)NOTE: Registration and payment are open from 01 February 2024 to 30 June 2024. We will close the registration and payment form 1-8 July 2024 for us to prepare for the 8th APCPH 2024. There will be an on-site registration and payment from 9-11 July 2024 at the fee of RM1200.00Instruction for Payment (Local Participants) Please transfer the payment amount to: Name: College of Public Health Medicine, Account No.: 514123134872 Bank: Maybank Please include the following details in the transfer: Participant's Full Name, NRIC/Passport, and the word "APCPH". You need to upload the proof of payment before you complete this form. Information on payment through eProlehan Kerajaan Malaysia (LPO) Upload Proof of Payment * Click or drag a file to this area to upload. Please upload the proof of payment (pdf, jpg or png)Declaration *In submitting this form, I confirm that all the information entered in this payment form is accurate and I have obtained permission from my workplace for payment through ePerolehan Kerajaan Malaysia (https://www.eperolehan.gov.my/).Declaration *In submitting this form, I confirm that all the information entered in this payment form is accurate and I have transferred the registration fees to the College of Public Health Medicine's Maybank Account (514123134872).Document Bayaran Download the payment documents for processing of eProlehan Kerajaan Malaysia. NextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit
