REGISTRATION FORM

Registration Options (Please tick where appropriate)

LOCAL PARTICIPANT Rate
Asia Pacific Society of Public Affairs (APSPA)
Members
RM 300.00

Non- APSPA Members RM 450.00
Student (APSPA Members) RM 100.00
Student (Non- APSPA Members) RM 150.00
INTERNATIONAL PARTICIPANT Rate
Asia Pacific Society of Public Affairs (APSPA)
Members
USD 100.00

Non- APSPA Members USD 150.00
Student (APSPA Members) USD 30.00
Student (Non- APSPA Members) USD 50.00
PANEL / INSTITUTIONAL
(3 - 5 presentersfor each group)
Rate

Local Panel/Institution RM 450.00 per person
International Panel/Institution USD150.00 per person

Thank you for registration. We look forward to see you at ICONPO IV on the 25
th
and 26
th
AUGUST 2014.
Please fax the completed forms to (+604- 928 7914) Attn: Pn. Nur Syakiran Akmal Ismail or alternatively send the forms to
website http://iconpoiv2014.uum.edu.my/. Thank you.

Please submit the registration form before 15
th
June, 2014
For any inquiries, please contact Dr. Halimah Abdul Manaf at 019-4742666 or email at
imah@uum.edu.my
PAYMENT REFERENCE
For credit card or online payment, please
provide the receipt number, date and amount
For cheque payment [Malaysia only], please
provide the cheque number and bank name
For LO [Malaysian only], please provide the LO
number


Do you want the vegetarian option?
Yes No

Kuala Lumpur Academic Excursions [Optional]
Yes No
[RM50/USD 16 will be charged for Tour Program]














PARTICIPANTS INFORMATION:
Name :
Institution :
Title / Position :
Address :

Tel [Office] : Tel [H/p] :
Email address :
Emergency contact name and number :
















INTERNATIONAL CONFERENCE ON PUBLIC ORGANIZATION IV (ICONPO IV)
25-26 August 2014
National Institute of Public Administration (INTAN) Bukit Kiara, Kuala Lumpur, Malaysia
Social Entrepreneurship: Driving Sustainable Change beyond The Millennium