Registration Form

International Participant
13th Thai Annual Orthopaedic Trauma Congress (TOTAC) 2025
February 19-21, 2025
@ Khao Yai Convention Center | KYCC, Nakhon Ratchasima, Thailand

Type Registration *

Country *

Prefix *

Name (ENG.) *

Surname (ENG.) *

Present Office / Institution *

Mobile *

Email *

Confirm Email *

Trauma Night (limited seats)

Join Trauma Night

Not join Trauma Night

Payment

Please pay

Cheque pay

Transfer

Account Name: THAI ORTHOPAEDIC TRAUMA SOCIETY (TOTS)
Account no: 051-282970-4
Bank Name: Siam Commercial Bank Public Company Limited
Bank Branch: Rajvithi Hospital Branch
Bank Address: Rajvithi Hospital, Rajavithi Rd., Rajthevee, Bangkok 10400,Thailand.
Swift code: SICOTHBK

Bank Name *

Payment Date *

Payment Time *

Payment Amount *

Proof of Payment (*.jpg, *.jpeg, *.png Only)

Contact: Miss Jutamas Chearanaya
The Royal College of Orthopaedic Surgeons of Thailand
4th floor, the Royal Golden Jubilee Building, 2 Soi Soonvijai, New Petchburi Road, Huaykwang, Bangkok 10310, THAILAND
Tel. (662) 716-5436-7 E-mail: [email protected]

Secure Image

Input Security Code *