Full Name:

1
APPLICATION FORM FOR POSTER PRESENTATION
SECRETARIAT Malaysian Dietitians Association
(MDA) Department of Nutrition Dietetics,
FSKB Universiti Kebangsaan Malaysia Jalan Raja
Muda Abdul Aziz 50300 Kuala Lumpur Malaysia
Deadline 26 May 2007
PRESENTER ( Please type in block letters )
Title Prof / Dr /Mr /Mrs / Ms
Full Name
( underline surname)
Address
Tel
Fax
Email
Mobile
Date_________________________
Signature____________________________________

• NOTE
• 1. All abstracts submitted for poster
  presentation at Malaysian Dietitians
  AssociationScientific Conference 2007, must be
  according to the Guidelines format given.
• Please email your Application Form for Poster
  Presentation together with your abstract
• to events_at_dietitians.org.my
• There will be two categories of competition for
  poster presentation I.e. one category for
  dietetic undergraduate students and another
  category for other professionals. Cash prizes
  will be given.