Membranes Workshop Registration
Sign in to Google to save your progress. Learn more
Name *
Designation *
Mailing Address *
Email *
Tel No. *
Fax No.
Registration *
Required
For group registration, please provide the name and designation of each of the participants
Method of payment *
Payment Information
Rates                 Student            Professional/Industry

Individual         RM 800                     RM 1000

Early bird*              RM 700                     RM 850

Group**                  RM 700/pax        


*Full payment must be made on or before 15th of Oct 2017
**Minimum of 3 persons per group
*** Payment can be made through the following methods:

(i) Payment via Telegraphic Transfer (T/T)

    Account                         : Bendahari Universiti Malaysia Perlis
    Account No                   : 09010001234710
    Beneficiary Address    : D/A BANGUNAN TNB LAMA, PERSIARAN JUBLI EMAS,
                                              01000 KANGAR, PERLIS,MALAYSIA
    Bank Name                   : Bank Muamalat Malaysia Berhad, Kangar Branch
    Bank Address               : No 85, Jalan Bandar Kangar,Kangar, 01000 Perlis Indera Kayangan
    Swift Code                    : BMMBMYKL
    Reference                     : 6008 - 00166

(ii) Payment via Internal Account Transfer (Using Internal Transfer Form) (for UniMAP staff and students ONLY)

       Account Name              : Workshop Membrane for Beginners
       Account No.                   : 6008 - 00166

**** Please email the proof of payment to membranesworkshop@gmail.com

CANCELLATION
Cancellation received in writing by the Secretariat 15 days prior to the workshop commencement date will receive refund less a handling free of RM 100. No refund will be given after this date.


Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy