A separate form must be completed for each registrant. Please photocopy the form if you need additional copies.
Online registration is available at http://conference.fsktm.um.edu.my OR complete the enclosed form. Forms received without payment or after 1 August 2005,; will be charge the on site registration fee. Accommodation is processed on a first-come, first-served basis, and rooms will be reserved after the deadline on a space-available basis only.
To register as a member, you must have had your 2005 membership activated or renewed before December 31, 2004. If you wish to join the IADR to take advantage of the lower membership registration fee, please pay your subscription separately. Membership applications are available online. If your membership subscription is not received and processed by the 1 August 2005 deadline date, you will be charged the full non-member registration rate for the meeting.
Requests for refunds for your registration and/or hotel accommodations must be received in writing, and refunds will be processed AFTER the meeting. Requests made on or before 7 August 2005 - refund less USD40 for processing fee; after 7 August 2005 - no refund.
A letter confirming your registration and acknowledging your hotel' accommodation will be sent to you within 7 days after your form is received via fax or e-mail.
Return to:
Dr. Noor Hayaty Abu Kasim
Dept. of Conservative Dentistry
Faculty of Dentistry
University of Malaya50603
Kuala LumpurMalaysia
e-mail: nha
at @um.edu.my
Tel: 603 7967 4806
Fax: 603 7967 4533
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