UST 2025 | Registration Form

REGISTRATION INSTRUCTIONS

1. Registration Fee:
EARLY BIRD RATE until January 31, 2025

REGULAR RATE

2. For BANK Deposit Payments:

upload

email

ust.postgraduatecourse@gmail.com

4. You will receive a confirmation email once your payment has been validated.

REGISTRATION FORM

LAST NAME*

FIRST NAME*

MIDDLE NAME

PRINT NAME AS TO APPEAR ON CERTIFICATE*

EMAIL ADDRESS*

MOBILE NUMBER *

PRC NUMBER*

PRC EXPIRY DATE*

PMA NUMBER *
(If PDS Residents, input your Hospital ID Number)

CATEGORY*

ONSITE

REGISTRATION AMOUNT

PROOF OF PAYMENT
Kindly upload your proof of payment.
If there are problems uploading the proof of payment, you may email instead toust.postgraduatecourse@gmail.com.
Please indicate your NAME on the proof of payment.

*Required Field

NOTE:
1. After submission, please wait for the successful confirmation message before closing the page.
2. If you do not receive the confirmation message within a few minutes of signing up, please check your SPAM folder.
If the confirmation email was sent to the SPAM folder, please select the confirmation message and click Not Spam, which will allow future messages to get through.

By registering in this post graduate course, I hereby confirm that I authorize USTH Department of Dermatology and its affiliates to collect, process, store the information provided in this registration form for legitimate business purposes, as proof of my attendance and participation in this event which may be published accordingly and for any follow up business activities related to my participation in this event. I give my consent for my NAME and EMAIL ADDRESS to be shared with the industry partners only for attendance purposes in the industry sessions.

For assistance regarding your registration, please contact technical support at
Text/Call: +639384414225 | Viber: +639384414225 | email: ust.postgraduatecourse@gmail.com