Registration Form for Participant

Registration Guidelines:

  1. Please enter your valid data.
  2. The space with the mark (*) is required to fill.
  3. Registration fee can be transferred to Bank Mandiri with Number Account: 1860000445284 and Account Holder: Vicardy Kempa. Please confirm your payment through WhatsApp Message to number +62 812-2022-2270 by sending the file of your payment proof.
  4. After registering, please check your email in order to join in The 2nd ICMMEd 2023 WhatsApp Group.
  5. If you have any problems or difficulties regarding to registration progress or any questions about The 2nd ICMMEd 2023, please contact us through WhatsApp Message or send your email to icmmedpattimurauniversity@gmail.com.

Note:
Registration fee for sit-in participant:
Early Bird
● Indonesia: IDR 100K
● International: $ 10 USD

Regular
● Indonesia : IDR 150K
● International: $ 20 USD