Nigerian Association of Oral & Maxillofacial Surgeons

REGISTRATION AND ACCOMODATION FORM

Do you want to attend the 4th Scientific Conference and Biennal General Meeting? Do it in two easy steps:

1. Pay the registration fee:

N 10,000.00 (Ten thousand naira) - Consultants and members
N 5,000.00 (Five thousand naira) - Resident Doctors

Account details: NAOMS Guaranty Trust Bank, 230677765110

2. Fill the form below to register and click enter to submit.

Please note that Fields marked * are mandatory

EVENT REGISTRATION FORM

Title*
Name*
Address*
Telephone *
Email*
Teller Number*

Any accompanying person *	Yes	No
Number of accompanying persons
I plan to present a (tick which)	Paper	Poster	Exhibition
If yes title

I wish to have accommodation booked at	(View Zaria Hotel Tariffs)
Room Type
Duration of stay	Days
From	of November 2010
To	of November 2010