Entry Submission – Medical Travel Media Awards

Submit for MTMA2020

Full Name (required)

Title (required)

Name of Media House (required)

Job Title (Please also state if you are a full-time employee or freelancer) (required)

Name of Editor (required)

Malaysian or Non-Malaysian / Others (required)

Address (required)

Address (2nd line)

City (required)

State / Province (required)

Postal/Zip Code (required)

Country (required)

Contact Number (required)

Work Email (required)

Malaysian Identity Card Number (required)

Passport Number (required)

Passport Expiry Date (required)

Award Category (required)