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* University

* Are You Currently A Student?

What Is Your Student ID?

* Medical Registration Number e.g.: For Doctors in Malaysia - Please enter your MMC No.

Which Country Are You Based In?

* Current Position

* Organization

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Premium (Annually)	MYR300.00 every year
Discount ( )	-MYR0.00

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Fee	MYR300.00 every year

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