Toggle navigation default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this form. Please, verify your browser parameters. Certificate in Infectious Diseases and Infection Control for Health Care Professionals (2025) Thank you for your interest in our course. You may register for the IDICC 2025 by providing your information through this registration form. Questions with the asterisk (*) are compulsory questions. (This question is mandatory) Title Prof. Dr. Mr. Mrs. Ms. (This question is mandatory) Surname (as it appears on your HKID card) (This question is mandatory) First Name (as it appears on your HKID card) (This question is mandatory) Chinese Name (as it appears on your HKID card) (This question is mandatory) Affiliation (e.g. Tuen Mun Hospital) (This question is mandatory) Department (This question is mandatory) Position (This question is mandatory) Correspondence Address (in full address) (This question is mandatory) Country (This question is mandatory) Mobile Phone Number Office Tel. Number (This question is mandatory) Email (Please provide an email address that you usually check)If you are currently a staff/student of PolyU, please provide your PolyU email address (@polyu.edu.hk / @connect.polyu.hk) (This question is mandatory) Language Proficiency Fluent Conversational Basic Nil English Fluent Conversational Basic Nil Cantonese Fluent Conversational Basic Nil Mandarin Fluent Conversational Basic Nil (This question is mandatory) Your preferred mode of attendance (Face-to-face/ Online via synchronous streaming)Participants are strongly encouraged to attend classes F2F. Warm reminder: Online mode will not include laboratory session or clinical visit. Please choose... Face-to-face class Online class (This question is mandatory) Are you likely to be sponsored by your employer? Yes, I will be sponsored No Don't know (This question is mandatory) How did you hear about our course? Poster in my place of work Email at my place of work Colleagues/Friends Nomination from supervisor or senior management Website of the Squina International Centre for Infection Control, School of Nursing, PolyU Promotional email from PolyU Other: If you are eligible for the special offer (other than the early-bird offer), please input your category and related supporting information, e.g. PolyU student number/ staff number, PolyU alumni ID number, etc. Personal Information Collection: Your supply of your Personal Data in this enrollment form is on a voluntary basis. The information you provide in this enrollment form and subsequently in the event of this enrollment form being either processed or given further effect will be used for the purposes of (i) the administration of this event; (ii) communication between the Organizer and you; (iii) collection of opinion; (iv) statistical and analytical purposes; and (v) direct marketing of this office’s future activities. It may be disclosed to other departments or units within the University for one or more of the purposes specified above. The Organizer will not disclose your personal data to any external body or organization unless your consent is sought, and it will not be used for any other commercial purpose. If you wish to access or correct your personal data records as kept by the Organizer, please send an email to sn.cic@polyu.edu.hk If you understand, agree and confirm the above information, please press the "submit" button below to submit your registration. Submit Please confirm you want to clear your response? Exit and clear form ×
