Please fill out the following fields to signup:
|Doctor, Healthcare, Professionals, Fellow, Resident, Researcher, Student, Others||160|
To complete your registration, please make the payment to the following bank account within 72 hours after submitting this form.
|Bank:||Banque Pour Le Commerce Exterieur Lao Public|
*Once the payment is completed, please upload an image of your payment slip to the payment and receipt.
If there are any issues, please contact our organizing team at firstname.lastname@example.org