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Billing details

1. MEMBER’S PARTICULARS

2. ADDRESS FOR CORRESPONDANCE (RESIDENCE / CLINIC)

3. CONTACT DETAILS

4. ACADEMIC QUALIFICATIONS

5. PRESENT EMPLOYMENT


The photo should not be greater than 1MB


Image of of educational (surgical) qualifications should not be greater than 1 MB

Additional information

Your order

Product Subtotal
International membership of HSI (US$100)  × 1 8,800.00
Asia Pacific Hernia Society (APHS) membership  × 1 8,800.00
Life membership of HSI  × 1 5,000.00
Subtotal 22,600.00
GST 4,068.00
Total 26,668.00
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