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students engagement registration
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Registration for Students' Engagement Session
Name as in per NRIC
Contact Number
Email Address
Citizenship
Singaporean
Permanent Resident
Other Nationality
Discipline
Audiology
Diagnostic Radiography
Medical Social Work
Nursing
Occupational Therapy
Pharmacy
Physiotherapy
Podiatry
Radiation Therapy
Respiratory Therapy
Speech Therapy
Others
I am a...
MOHH/ANS Scholar allocated to Sengkang General Hospital
Sengkang General Hospital Sponsored Student
None of the above
Only one guest is allowed to attend this session with you. Please indicate his/her name below (if applicable).
As we are ordering refreshment, we would need to confirm the number of people who will be attending.
Dietary Preference (if any)
Please state the name(s) of the registrant(s) and their respective dietary preference. eg. Andy Tan - Vegetarian
Personal Data Protection Act (PDPA)
I consent to Sengkang General Hospital Pte Ltd (SKH) and its related corporations (collectively SingHealth), their agent(s) and Sengkang General Hospital's authorized service providers collecting, using, disclosing and/or processing my personal data for matters related to the SKH Student Engagement undertaken.
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Name
10/3/2018 5:47 PM
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