REGISTRATION FEE:
Date of Application: Title: 
(as you wish it to be printed on the certificate.) (as you wish it to be printed on the certificate.)
First Name: Last Name: 
Saudi Commission for Health Specialties Registration Number *
Iqama/Saudi ID # *
Institution:
Address: Country:
Gender: *
Occupation/Profession:
Primary Specialty:
(if applicable)
Mobile Number:* Fax Number:
Email Address:
Mode of Transport:* By Road Via King Khalid International Airport, Riyadh
Via Qaisumah Airport Via K.K.M.C. Airport, Hafar Al Batin
Date of Arrival: (dd/mm/yyyy) Flight detail:
Date of Departure: (dd/mm/yyyy) Flight detail:
   

Bank Deposit per payment:
Bank Name: NCB (AlAhli) Acc Name: NAAFH Hospital
IBAN: SA89 1000 00 06654804000101

    Download Registration Form

Please Re-Confirm your Registration before your arrival to KKMC by calling 037871777 ext. 2818/2931/2705

You must submit your Saudi ID/IQAMA copy with this for Preparation of gate Pass

eMail:conferencekkmch@live.com                                FAX : +966 3 787 1382

SUBMIT REGISTRATION TO:
Coordinator, Organising Committee
Northern Area Armed Forces Hospital
P O Box: 10018 
Hafer Al Batin 31991
Kingdom of Saudi Arabia
  Tel : +966 3 7871777 ext. 2818/2221
Fax : +966 3 787 1382
  : +966 3 787 3101
Email : conferencekkmch@live.com
Web : www.kkmch.med.sa