Document 335784

International Conference on
“Simulations, Simulated and
Standardized Patients in Health
Professionals’ Education”
21st and 22nd November 2014, at
University of Health Sciences (UHS) Lahore, Pakistan
(Pre-conference Workshops on the 20th of November 2014)
Registration Form
Part-I: Bio-data
Name
Name to be printed on
certificate
Designation / Job Title
Country
Institution
Faculty/School/Centre
Department/Hospital
Address
City/State
Zip/Postal Code
Landline
Cell
Fax
Email
Alternative Email
Part-II: Registration Charges
Category
Registration fee
Before 14th November, 2014 After 14th November, 2014
Please check the relevant box
PKR
US$
PKR
US$
Conference days 21st and 22nd November, 2014
National Faculty/Staff
w
International
w
Postgraduate students
w
500
1000
Undergraduate students
w
100
100
500
1000
100
150
Pre-conference Workshop – 20th November 2014
Time
09:00 am
to
12:00 noon
02:00 pm
to
05:00 pm
Workshop Title
Involving real patients in health profession’s teaching and
research
Facilitator
Dr. Vikram Jha
Dr. Gohar Wajid
&
Dr. Idrees Anwer
Establishing simulation center in a medical college:
experience from Rawalpindi medical college
‘The Good, The Bad & The Ugly’: Assessment of
Attitudes and Ethics in Health Professionals
Will be provided soon
Will be provided soon
Using simulated patients for learning and assessment of
clinical skills
Workplace-based assessment
Will be provided soon
Dr. Mowaddat H. Rana
Dr. Usman Mahboob
Dr. Kay Mohanna
Dr. Amina Ahmed
Dr. Gominda Ponnamperuma
Dr. Syed Hassan Shoaib
Note: That only one workshop from the morning and one from the evening slot can be booked.
National Faculty / Staff
w
1000 per
workshop
Undergraduate students
w
500 per
workshop
International
w
US$ 250 per workshop
Gala Dinner – 21st November 2014 at 08:00 pm
National Faculty and Staff
w
International
National Accompanying
Person
International Accompanying
Person
Dietary Preference for
Conference Dinner
Total Amount
w
w
1500
US $ 50
1000
w
w
US $ 40
w Vegetarian
w Non-Vegetarian
Part-III: Mode of Payment
(Seats are confirmed upon receipt of Payment)
Registration is on a first-come first-served basis upon receipt of full payment.
Please make your Bank Draft payable to Treasurer, University of Health Sciences Lahore-Pakistan and
on the reverse side of Bank Draft, please indicate “Simulations 2014”.
Mail your Bank Draft at the given address:
Office of the Pro-Vice Chancellor
University of Health Sciences (UHS)
Khayaban-e-Jamia Punjab, University Road,
Lahore - 54600, Pakistan.
Tel: 042-99237109
Cancellation Policy
Any cancellation or replacement must be conveyed to the organizers in writing. Cancellation charges of
50% fee will be levied if the cancellation is received on or before 14th November, 2014. There will be no
fee refund if the cancellation is received after 14th November, 2014.
Part-IV: Acknowledgment
Please send us an email/Fax to confirm your registration and detail of posted bank draft. Confirmation on
your registration will be sent to you when we will receive your full payment. An official receipt will be sent
to you within 10 working days upon receipt of payment. For any query regarding you registration, please
contact at the following address:
Conference Secretariat:
Office of the Pro-Vice Chancellor
University of Health Sciences,
Khayaban-e-Jamia Punjab, Lahore – 54600 – Pakistan
Phone No.+92 42 99231305-09, Fax No.: +92 42 99230870
E-mail: [email protected]
Website: www.uhs.edu.pk
Part-V: Accommodation
Subsidized accommodation is available for conference attendees at the following hotels :
Hotel
Hotel View Garden
Shadman Chowk Lahore
Motel Residence
10-A Block-D New Muslim Town Lahore
Silver Star Hotel
6-B-II Block H Near SherPao Bridge Lahore
Hotel Royal Yorke
109, J-Block Johar Town Lahore
Regency Hotel
Near Sherpau bridge Gulberg Lahore
Corporate Inn Residency
111-J Block Model Town Lahore
Ambassador Hotel
7 Davis Road, Shimla Hill, Lahore
Ph: 42-36316820 Fax: 42-36301868
Shalimar Tower Hotel
24 Main Gulberg Jail Road Lahore
Sun fort Hotel
72-D/1, Liberty Commercial Zone, GulbergIII, Lahore, Pakistan.
Ph: 042-576 3810 - 19 Fax: 042-575 4277
Hospitality Inn Hotel
25-26 Egerton Road, Lahore.
Rate
Single
Double
2000 + Tax
2500 + Tax
2000 + Tax
2500 + Tax
2500 + Tax
3000 + Tax
3000
3500
3500 + Tax
4500 + Tax
3500 + Tax
4000 + Tax
4000
4500
4000 + Tax
5000 + Tax
5500
6500
6500
8500
9300 + Tax
11300 + Tax
Pearl Continental
Shahrah-e-Quaid-e-Azam
P.O.Box#983,Lahore
Ph: (42) 3636-0210, 111-505-505
Fax:+92(42) 3636-2760, 3636-4362
The above rates are valid (subject to availability) until 22nd November, 2014. After this cutoff
date, it is at the hotels discretion whether to accept additional reservations, which will be
subject to prevailing rates and availability.
Looking forward to welcoming you in Lahore, Pakistan and wishing you
a safe travel.