Reservation Form via Fax     

Please  Fill and Sign then reply to us by fax to our Malaysia office. Fax : (+609) 624 2572

Personal Information

First Name

Surname

Passport/IC Number

Nationality

Address

City

  Zip/Postal Code 

State

Country

Hand Phone No

   Fax 

Email

Delegate Residential / Non Residential Package

Technical Tour

  I will join the Setiu Wet Land Tour              No thank you. I will not be joining the tour.

Payment Company cheaque /Local Order/ Telegraphic Transfer

Bank : (For local payment only, company cheque, TT, bank draft, cashier order)

Account Name : Persatuan Pelancongan Negeri Terengganu

Account No : 013014109986

Bank Name : Maybank Kuala Terengganu

Closing Date : 28 October 2010

Cancellations

All payment is not refundable.

Admittance

I hereby accept all terms of participation without reservation or restriction and that we relinquish any claims against the organizer (the organizer reserves the right to cancel or postpone the conference due to unforeseen circumstances. The organizer shall charge propotionately and refund the balance). The undersigned hereby represents and warrants that he/she is duly authorized to execute this binding contract on behalf of the delegates above.

Signature

Name

 Reg No: