Music Jamboree Application Form
A gathering, exchange and exploration of innovative teaching techniques.

Date: 1-6 June 2015 (Monday ~ Saturday)
Venue: Hotel Continental, Penang, Malaysia
Early Bird Fee: *RM550.00 (USD215.00) per person inclusive of 5 nights "TWIN-sharing" basis accommodations with breakfast (subject to availability at time of confirmation). For Single Occupancy Basis, RM750.00 (USD275.00) per person.
*Secure your place before 31 March 2015. After that, FULL application fee will be RM750.00 (USD275.00) per person and for Single Occupancy Basis, RM950.00 (USD335.00) per person.

Check-in: Monday, 1 June 2015
Check-out: Saturday, 6 June 2015

Please fill in the form below and press the 'Submit' button and we'll respond back to you via email. For more information, click on http://www.rhythmmp.com/2009/06/music-jamboree.html or email rhythmmp@mphsb.com. We look forward to having you with us!

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How did you hear about Music Jamboree? *
Required
I wish to attend the following *
This is my *
Title: *
Surname (last name): *
(Surname / last name is family name, as per MyKad / national identity card / passport)
Given name (first name): *
(exactly as per MyKad / national identity card / passport)
Email: *
Mobile phone: *
(Country code - Area code - Phone number) e.g. 60-12-4083604
Website / Blog / Facebook link:
Address:
City / Town: *
State / Province: *
Zip / Post code: *
Country: *
Please choose one of the following payment options: *
(Please email a scan / print screen / photo image of your payment document / receipt to rhythmmp@mphsb.com stating your payment amount, payment date and remitter's name)
Please state your payment currency and amount: *
USD215.00 for payments from outside Malaysia. RM550.00 MYR for payments within Malaysia. • Recipient name: Rhythm MP Sdn. Bhd.  • Recipient bank name: Malayan Banking Berhad  • Recipient bank address: Auto World Complex, Jalan Perusahaan, Juru Interchange, 13600 Prai, Penang, Malaysia.  • Recipient account number: 507303 000155  • Swift Code / BIC: MBBEMYKL
Please state your payment / transaction date: *
day / month / year
Please state remitter's name / payment reference / cheque number: *
Employers: *
Remarks:
Arrival and departure airline, flight no, date, time and other remarks
Rhythm MP Sdn. Bhd.
1947, Lorong IKS Bukit Minyak 2,
Taman IKS Bukit Minyak,
14100 Simpang Ampat,
Penang, Malaysia.
Tel: +60 4 5050246, 5073690 ext. 511 or press '2' for Rhythm MP
Fax: +60 4 5050691
Email: rhythmmp@mphsb.com 
Website: http://www.rhythmmp.com/ 
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