Registration Form via Fax     

Please  Fill and Sign then reply to us by fax to our office. Fax : (+609) 626 2022

Personal Information

First Name

 

Surname

Passport/IC Number

Nationality

Address

 

City

  Zip/Postal Code 

State

Country

  

Hand Phone No

   Fax 

Email

Conference Fee

Registration Fee: RM 100.00

  • Per person

  • Inclusive : 3 Tea Break / 2 Lunch / 1 Dinner
Accommodation : RM 190.00

No. Of Nights :

  • Per room per night with breakfast
  • Twin or Single occupancy

Technical Tour

 

  I will join the Birthwatching Experience with Mr.Anuar Mc.Afee            No thank you. I will not be joining the tour.

Payment Company cheque /Local Order/ Telegraphic Transfer

 

 
 Amount
RM   No

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

Account Name : Batik Gallery

Account No : 13020019881055

Bank Name : CIMB Bank Kuala Terengganu

 

 

Closing Date : 15th  September 2011

 

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

Date
 

Contact Person:
Ms.Mila or Ms.Zati

77A Jalan Sultan Sulaiman,
20000 Kuala Terengganu,
Terengganu Darul Iman,
 Malaysia


Tel : +609-626 2020      Fax : +609-626 2022
E-mail : info@terengganutourism.com
Website : www.terengganutourism.com/TEMCO2011/TEMCO_Home
 
 For Office Use :

 Reg No:

 
Organised by :  
   

please click here to print