APPENDIX 4

NaCoSC16 - Registration form

http://nacsc-puo.blogspot.com/
NaCoSC16 will be held on May 04, 2016 at Politeknik Ungku Omar. Please note that it is essential for all
participants to send in a completed Registration Form, Final Papers and Registration Fee to
nacscpuo@yahoo.com before April 20, 2016.
1. PERSONAL INFORMATION
Presenters Name:
(Certificate of presentation will be prepared under this name. Only one presenter could present with one
registration.)
Position: Prof. Associate Prof. Assistant Prof. Lecturer Student: Ph. D Master Others
Organization:

Telephone No:
State:
Subtheme:
Paper Title:

email:
Country:

Postcode:

If you need more information of NaCoSC16, please browse the website: http://nacsc-puo.blogspot.com/
2. REGISTRATION FEE
Registration Fee
nil
nil
RM 50.00

Please Tick ()

Presenter (Politeknik Ungku Omar)

Participant
Presenter (students & Politeknik Malaysia &
Community Colleges)
Presenter (from other institutions)
RM100.00
The payment should be made in Ringgit Malaysia (RM) only no later than April 20, 2016. All payments made need to
be accompanied by proof of payment (i.e. bank-in slip / online bank transfer payment) to be emailed to the
nacscpuo@yahoo.com and c.c to nfariza@puo.edu.my and yukarni@puo.edu.my
NaCoSC16 Bank Account Info
Beneficiary : KOPERASI POLITEKNIK UNGKU OMAR BERHAD
Account No. : 558172100170
Bank Name : ISLAMIC CURRENT ACCOUNT (MAY BANK)
Please send NaCoSC16 Registration Form to nacscpuo@yahoo.com.
No Refund Policy
There will be no refund policy to non attendance participants. However, non attendance participants may send
substitute person with no addition charge. Please inform us immediately if you cannot come.