NXGN (NEXTGEN) Aged Care & Wellness Conference & Exhibition

Online Registration Form

Date: 02 September 2023

Venue: Komune Living & Wellness, 21, Jalan Tasik Permaisuri 2, Bandar Tun Razak, 56000 Kuala Lumpur, WP Kuala Lumpur Malaysia.

For further details please visit: www.uoa-academy.com/NXGN

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* 1. Please choose your rate. (For attending conference only. No registration required for attending exhibition)

Conference Participant: RM 599 - Public Rate Per Person

Conference Participant: RM 399: Senior Citizen's Rate Per Person

Conference Participant: RM 1000: Family / Group Rate inclusive for 3 Persons

Associations / Endorser / Conference Partner Rate

Special Offer (Offer from 1st - 7th August 2023): RM 349 Per Person - For Public & Senior Citizen's Rate

Others

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* 2. Kindly indicate as per the following - If you are registering under Associations / Endorser / Conference Partner:

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* 3. Mode of Payment:

HRD Corp Claimable

Bank Transfer

Other (please specify)

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* 4. Kindly provide the registered company name for the HRDC Grant Application. If you are opting for a different mode of payment, please write "N/A" in the respective field.

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* 5. Do you require accommodation?

Yes

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* 6. Nature of Business:

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* 7. Please state if you are a Vegetarian:

Yes

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* 8. Do you have any food allergies? If yes, please state your allergy below:

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* 9. Submitted by

Name

Designation

Company Address

Email Address

Phone Number

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* 10. Participant 1

Name

Preferred Name (Name Badge)

Designation

Company Address

Email Address

Phone Number

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* 11. Participant 2

Name

Preferred Name (Name Badge)

Designation

Company Address

Email Address

Phone Number

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* 12. Participant 3

Name

Designation

Company Address

Email Address

Phone Number

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* 13. Participant 4

Name

Designation

Company Address

Email Address

Phone Number

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* 14. Participant 5

Name

Designation

Company Address

Email Address

Phone Number

Thank you for the registration. We will be in contact with you soon for further process.
For any enquiries, please contact Mr Aqmal Fikri at:

UOA Academy Sdn Bhd
UOA Corporate Tower, Lobby A, Avenue 10, The Vertical
Bangsar South City, No 8 Jalan Kerinchi
59200 Kuala Lumpur, Malaysia.
Tel: 6016-241 3517
Email: register@uoa-academy.com