Participant Event Registration - Sian Chay Medical Institution

Event Registration Back

First Name *

Last Name

Identification Number

Enter the last 3 numbers and alphabet of your Identification Number.

Gender

Male

Female

Date of birth *

Contact No.

Email *

Address *

Zip Code

Remarks

By clicking "I Agree", I hereby consent for the collection, use and disclosure of my personal data provided in this form, by Sian Chay Medical Institution for the purpose set out in the Privacy Policy accessible here . I agree that Sian Chay Medical Institution and its affiliates, including but not limited to its service providers, may call me, send marketing messages to me about their products and services via SMS, MMS, Instant Messaging (Whatsapp) or email.