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Form Registration
Please fill out the form below to register.
REGISTRATION FEE
Title & Full Name / Gelar & Nama Lengkap
(as written in your certificate)
Nationality / Kewarganegaraan
Select an option / Pilih Salah Satu
Indonesian
Non Indonesian
Category / Kategori
Select an option / Pilih Salah Satu
Participant / Peserta Umum
Presentator / Oral Persentasi
Institution / Asal Institusi
Select an Institution / Pilih Salah Satu
Alma Ata University
Others / Institusi Lainnya
Status
Select an option
Undergraduate Student
Alma Ata Lecturer
Alma Ata Student
Postgraduate Student
General / Professional
Metode
Select an option / Pilih salah satu
Offline
Online
Educational background
Select an option
Nutrition
Pharmacy
Hospital Administration
Nursing
Midwifery
Public Health
Other
Phone number (WhatsApp)
E-mail:
required email
