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  • Registration Form: World Innovation Forum Kuala Lumpur

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    Muhammad Hafiz
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    This document contains a registration form for the World Innovation Forum in Kuala Lumpur from November 1-7, 2012. It requests information such as names, organization details, job title, dietary preferences, and contact information. It outlines the registration categories and fees, which differ based on early or late registration and domestic vs international participants. It also requests the number of delegates attending an innovation awards event on November 6. Finally, it provides payment details and registration information contact details.

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    This document contains a registration form for the World Innovation Forum in Kuala Lumpur from November 1-7, 2012. It requests information such as names, organization details, job title, dietary preferences, and contact information. It outlines the registration categories and fees, which differ based on early or late registration and domestic vs international participants. It also requests the number of delegates attending an innovation awards event on November 6. Finally, it provides payment details and registration information contact details.

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    3 views1 page

    Registration Form: World Innovation Forum Kuala Lumpur

    Uploaded by

    Muhammad Hafiz
    This document contains a registration form for the World Innovation Forum in Kuala Lumpur from November 1-7, 2012. It requests information such as names, organization details, job title, dietary preferences, and contact information. It outlines the registration categories and fees, which differ based on early or late registration and domestic vs international participants. It also requests the number of delegates attending an innovation awards event on November 6. Finally, it provides payment details and registration information contact details.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    WORLD INNOVATION FORUM KUALA LUMPUR

    PART 1 | ORGANISATION DETAILS


    Names (1) (2) (3) (4) Organisation / Institution Address Country City Telephone Email Dietary Preferences Vegetarian Diabetic

    1-7 NOVEMBER 2012 Kuala Lumpur Convention Centre MALAYSIA

    REGISTRATION FORM

    Job Title (1) (2) (3) (4)

    State Fax Signature

    Postal Code / ZIP Mobile

    Other

    PART 2 | REGISTRATION CATEGORY


    Category Government , NGO Others International Participants On and before 30 Sept 2012 MYR500 MYR700 USD500 After 30 Sept 2012 MYR1000 MYR1400 USD1000 No. of delegates Total (MYR/USD)

    PART 3 | ATTENDANCE CONFIRMATION FOR WIF-KL INNOVATION AWARDS NITE


    Event WIF-KL Innovation Awards Nite (6 Nov 2012, 8:00 pm 10:00pm) No. of delegates to attend

    PART 4 | PAYMENT DETAILS


    Payment can be made via cheque/bank draft/local order/ telegraphic transfer made payable to: YAYASAN INOVASI MALAYSIA Unit E001, Ground Floor Block 3440, Enterprise Building 1 Jalan Teknokrat 3 63000 Cyberjaya, Selangor Darul Ehsan, MALAYSIA Details of the bank account are as below:

    BANKNAME BRANCH CODE SWIFT CODE ACCOUNT NUMBER

    : Malayan Banking Berhad : 66010 : MBBEMYKL : 5660 1055 2207

    REGISTRATION INFORMATION

    www.wifkl.com +603 8319 1714 +603 8319 1715 klif@yim.my World Innovation Forum - Kuala Lumpur

    Kindly email or fax the completed form to: For enquiries and feedbacks, kindly contact us at:

    klif@yim.my +603 8319 1715 Yayasan Inovasi Malaysia (YIM) Unit E001, Ground Floor Block 3440, Enterprise Building 1 Jalan Teknokrat 3 63000 Cyberjaya, Selangor Darul Ehsan, MALAYSIA.

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