Registration Form
3rd Annual International Conference on Cardiology & Cardiovascular Medicine Research
(CCMR 2017)
Date: 20 – 21 February 2017, Singapore
Please fill in the form, sign by hand, and send it via one of the following:
Fax: +65 6327 0162 / E-mail:
Title (Student/Prof/Dr): _____ First Name: ______Last Name: ______
Paper ID: ____ Paper Title: ______(for authors only)
Institution: ______
Street Address: ______
City: ______State: ______Country: ______Zip: ______
Phone: ______Fax: ______Email: ______
Dietary Requirements: ______Attending conference: Yes / No
Conference Registration Fees
The full registration fee includes: Keynote & invited speakers session(s) (if any), concurrent sessions of Technical Program, Conference Proceedings, lunch, morning and afternoon refreshment breaks and GSTF Polo T Shirt.
Ladies’ Polo T-Shirt Size: S “36
Men’s Polo T-Shirt Size: S “38 M “40 L “42 XL “44
Become a GSTF Associate Member (+ SGD 40) Become a GSTF Student Member (+ SGD 25)
(Members will avail of the subsidized fees as indicated on the next page)
Regular Papers
Tick appropriate category / Category / Registration Fee (SGD)For Regular Papers
Early-bird registration - Author (GSTF Member) / 800
Early-bird registration - Author (Student) / 800
Early-bird registration - Author (Non Member) / 850
Additional Authors / 500/pax
Additional Papers / 430/paper
Extra Pages (up to 4 extra pages) / 80/page
Late registration - Author (GSTF Member) / 1000
Late registration - Author (Student) / 1000
Late registration - Author (Non Member) / 1100
For Posters & Extended Abstracts
Early-bird registration - Author (GSTF Member) / 600
Early-bird registration - Author (Student) / 600
Early-bird registration - Author (Non Member) / 650
Additional Authors / 450/pax
Additional Posters/EAs / 300/paper
Late registration - Author (GSTF Member) / 775
Late registration - Author (Student) / 775
Late registration - Author (Non Member) / 825
For Non-Authors
Early-bird registration - Non-Author Participant / 670
Early-bird registration - Non-Author Participant (Proceedings) / 770
Late registration - Non-Author Participant / 770
Late registration - Non-Author Participant (Proceedings) / 870
Returning delegates
Tick appropriate category / Category / Registration Fee (SGD)Early Bird Registration - Author (Non Member) / 650
Early Bird Registration - Member / student / 600
Late Registration - Author (Non Member) / 750
Late Registration - Member / student / 700
Note:
- In order to avail of the student rates, a formal letter from their University is required.
- If the registered participant is unable to attend, the registration may be transferred to another presenter. S/he must inform the Conference Secretariat a month before the conference. No refunds will be issued.
Payment methods Please indicate the paper ID and title in the payment slip.
1. Wire transfer (TT)Account Name: ‘Global Science and Technology Forum Pte Ltd’
Bank Name: United Overseas Bank (UOB)
Bank Address: Anson Road, #01-01 International Plaza, Singapore 079903
Please email the Conference Secretariat for more information.
* For wire transfer, please add SGD 45.00 for local/overseas bank charges. / 2. Credit/Debit Cards
Payment can be made online via PayPal. Please follow the link provided on the conference website.
Please email the Conference Secretariat your PayPal payment slip along with the registration form.
*All PayPal transactions will include a 5% PayPal administrative fee.
Author’s Signature and date: