Thai Resident – Regis-RJ

Thai Resident/Fellowship

bone and ear th 29th 2026

Title

First Name

Last Name

(as you would like to be addressed)

Position

Academic/Hospital Affiliation(s)

City

Country

Email address

Dietary restrictions

None

Vegan

Halal

Lectures & Live Surgical Demontrations (No Hands-on Dissection) ๔,๐๐๐ บาท

Need a receipt for government reimbursement

Yes

Total Register fee

Bank / Telegraphic Transfer

Account Name: Center of Excellence in Otolaryngology, Rajavithi Hospital

Account No.: 051-273420-0

Bank Name: The Siam Commercial Bank PCL

Swift code: SICOTHBK

Bank Address: 9 RATCHADAPISEK ROAD, CHATUCHAK, BANGKOK 10900, THAILAND

Branch Code: 0051

**The registrant shall be responsible for all international transfer fees.**

Please attach proof of payment.

Maximum file size: 5MB

(a file extension PDF. or JPG. only)

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