Bach Mai Hospital
78 Giai Phong Road - Ha Noi - Viet Nam
Telephone: (84.24) 38686390 Fax: (84.24) 38687524
REGISTRATION FORM
THE FIRST INTERNATIONAL NURSING RESEARCH CONFERENCE
“Training and developing nursing research in nursing care”
Bach Mai hospital, Ha Noi, Viet Nam
November 29th - 30th 2017
Dear Colleagues,
All participants are requested to fill this form and send it to the conference secretary Mr. Long Ha Hai, RN. Email: before October 15th, 2017
International Conference
“Training and developing nursing research in nursing care”
Date: November 29th -30th 2017
Venue: Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Ha Noi, Viet Nam
1. General Information
Title/Position: ______
Family name: ______
First name: ______
Organization/Institution: ______
Address: ______
Postal/Zip code: City: ______
Country: ______
Telephone: ______
Fax: ______
E-mail: ______
2. Passport Details
Passport Number______Issuing Country______
Name on passport ______
Birth Date______
Date of Issued______Date of Expired______
3. Benefits of the conference
- 01 Journal of Clinical Medicine
- 01 Scientific conference document
- Certificate of attendance conference (20h continuous medical training)
- Gala dinner, lunch and tea-break
- Conference gift.
4. Payment
- Registration fee: 100 USD (only receiving by cash)
- Fee for accommodation, transportation (air ticket/taxi…): paid by yourself.
Notice: You can pay directly when you come to the conference or paying by using our account
- Name of bank: Military Bank – Thang Long Branch
- Account number:0541101064008
- SIWP CODE: MSCBVNVX
- Website: www.mbbank.com.vn
5. Certification
Please provide your information which you need to show in the certificate
- Name: ______
- Content: ______
6. Accommodation:
We recommend a list of hotels near Bach Mai Hospital you can book:
- Nikko Hanoi Hotel
84 Tran Nhan Tong Street, Hai Ba Trung District, Hanoi. +(84-24)-3822-3535
http://www.hotelnikkohanoi.com.vn/
- Kim Lien Hotel
No.5-7.Dao Duy Anh Street, Dong Da District, Hanoi. +(84-24)-3577-0328
http://kimlientourism.com.vn/
- Hoa Hong Hotel
No.250.Dao Duy Anh Street, Dong Da District, Hanoi. +(84-24)-3852-9628
http://khachsanhoahong.vn/Index.aspx
- Hanoi Gold Hotel
No.24. Lane 4. Phuong Mai Street, Dong Da District, Hanoi. +(84-24)-3852-9999
https://goo.gl/YrjUAv
Thank you and we look forward to seeing you in the meeting