Registration Form

A. Login Details

Confirm Password*:

B. Personal Details

Title / Salutation*:

Full Name*:

Nationality*:

IC (Malaysian) / Passport Number (International)*:

Upload 1st Page of Passport:

Mobile Number*:

Address*:

City *

State *

Postcode *

Member Category*:

**Malaysian Malaysian Radiology Trainees / Candidate Member / Medical Officer do attach a letter from the HOD as the Supporting Document for verification.

Institution / Organisation*:

Profession*:

Meal Preference*:

How do you know about this event?*:

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