pre
registration form


Please complete all the required field ( * )

Name * :
Job title * :  
Company * :
Mailing address * :
E-mail address * :
Reconfirm E-mail * :
Phone no * :
Fax no * :
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1. The classification which best describes your organisation is? (Please tick)

01. Acedemician
02. Health Ministry Officials
03. Chemical Plant / Factory
04. Construction
05. Consultancy
06. Development
07. Distributor / Agent / Wholesaler
08. Distributor / Manufacturer's Representative / Vendor
09. Doctors (Surgeries and Hospital)
10. Education & Training / Research & Development
11. Nursing Officers
12. Biologists, Biochemists, Technicians
13 Dispensing Chemists, Pharmacists
14. Rehabilitation Organisations, Nursing Homes
15. Care Services & Self-help groups
16. Goverment / Department
17..
Others(please Specify)
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2. Which best desribes your job title? (Please tick)
01. Chairman
02. Consultant
03. Director
04. Design / Development
05. Managing Director
06. Plant Manager
07. Procurement / Purchasing
08.
Others (Please specify)
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3. Do you specify, approve, purchase or influence the purchaser of products and service in
your organisations?
01. Yes
02. No
 
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4. How many employees are there in your company / department (all locations)? (Please tick)
01. 1 - 20
02. 21 - 100
03. Over 100
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5. How did you come to know of MEDEX 2019? (Please tick)
01. Newspaper
02. Magazine
03. Main Invitation
04. Online Newsletter
05. Online Websites
06.
Others ( Please specify)
We will send you the Pre-registration Letter (if you qualify).
Note : Each Pre-registration Letter is for admission of one person only.You must print a copy of the Pre-registration Letter and bring along to the Visitor Registration Counter at the entrance of the Tatmadaw Hall where you will be issued a Visitor Badge.