18th Asian Colloquium in Nephrology
19 - 21 July 2019
Grand Ballroom, Level 1, ParkRoyal on Beach Road

*If you would like to register as Trainee/ Resident/ Nurse/ Student registration type, please kindly provide your ID or relative proof document while signing up the account. If the document is not qualified, we will ask for the full-registration fee for the conference participation. Thank you!

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Last Name / Surname*
Job Title*
Company/Organization/Institution*
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Address Line 2
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State/Province
Country*
Zip (Postal Code)*
Food Preference (please tick one & Kosha meal will not be provided)
If dietary requirement is Others, please specify

Personal Data Protection Policy (PDPA) and General Data Protection Regulation (GDPR)
The Organiser (SSN, ARA & SOTANC) and their appointed Management Company, Ace:Daytons Direct take Data Protection seriously and adhere to European and Singapore Data Protection legislations which govern the collection and management of personal information. Subsequent to this event, the Organiser and Ace:Daytons Direct will use your contact details to provide you with copies of conference materials and to solicit feedback on the event itself. The Organiser may also wish to inform you of subsequent SSN Conferences, Courses and/or SSN Events.

To read the SSN’s full data policy please visit

Do you consent to the Organiser using your contact details in the ways described above?
Do you consent to the Organiser contacting you with details on future SSN Conferences, Courses and events and abstract submissions of this type?
Would you like Ace:Daytons Direct to make your contact details available to selected third parties that may be of interest to you?
MCR/ SNB / CPE No
Special (Please specify any access needs you have e.g. wheelchair user, mobility difficulties, hearing impaired etc:
Do you have a Medical Degree?
Is your main specialty?
What are your main areas of interest? Please select all that apply:  Bone & Mineral Metabolism
  Chronic Kidney Disease
  Development & Paediatrics
  Diabetes & Metabolism
  Dialysis
  Genetic Disease of Kidney
  Geriatric Nephrology
  Glomerular Diseases
  Hypertension & Cardiovascular Disease
  Interventional Nephrology
  Cell and Transport Physiology
  Pathololgy
  Transplantation & Immunology
  Others
If main area of interest is Others, please specify
How did you hear about Asian Colloquium in Nephrology? Please select all that apply:  From the Organiser
  Conference Website
  Word of Mouth
  our Society
  Medical Journal
  Others
If Others, please specify
Profession  Doctor
  Nurse
  Pharmacist
  Allied Health
  Admin / Others
  Student
  Lecturer / Trainer / Educator
MCR/ SNB No
Upload your proof document as Trainee/ Resident/ Nurse/ Student