IMS ASIA SDN BHD (448949-H

)
501 Level 5, Bangunan TH Uptown 3, No. 3, Jalan SS21/39, 47400 Petaling Jaya, Selangor Darul Ehsan, Malaysia.
Tel: + (603) 7710 1360 Fax: + (603) 7710 1361 Email: info@imsasia.com http://www.imsasia.com




REGISTRATION FORM FOR MOSC, 24-25 September 2014
To confirm your registration, kindly complete this form and fax to us at +603-77101361 or email: info@imsasia.com
For course enquiry, please contact us at +603-77101360 or visit Website: http://www.imsasia.com

MOSC 2014 Event Fees

*REGULAR FEE INDIVIDUAL FEE
Malaysian Government /
Public Learning
Institutions
RM650

RM 375
Private Companies RM750
RM425
Student RM500
RM300
Past Delegate RM600
RM350


Company Details
Company Name:

Manager/Contact
Person’s Name:

Mailing Address:
Designation:
Department:
Phone: Phone/Fax:
Email Address:

Payment Method

Bill to Company/Cheque

Purchase Order /Local Order
* Please email us the payment slip once payment has been made*


Accounts Payable Contact Person: Phone:
Billing Address: Email:

Participant Details

No. Participant’s Name Designation Email Address











Note: The fee includes lunch, refreshments, and event giveaways. This event is PSMB/HRDF claimable under *SBL Scheme
*(Subject to PSMB/HRDF approval)

TERMS AND CONDITIONS
1. Upon receipt of a completed registration form, it confirms that the organization is registering for the seat(s) of the participant(s) to attend the
conference
2. Payment is required with registration and must be received prior to confirmation seat.
3. Payment is non-refundable.
4. Walk-in participant with payment will only be admitted on the basis of seat availability at the event and with immediate full payment.
5. The organizer reserves the right to make any amendments and/or changes to the workshop, venue, facilitator replacements and/or modules if
warranted by circumstances beyond its control.

ACCEPTANCE
I/We hereby agree to abide by all the terms and conditions as stipulated by IMS Asia Sdn Bhd.




Authorized Signatory / Name Date Company Stamp



GOOD NEWS!
For Every Regular Fee
Registration
Get 1 Free Seat!
(2 for the price of 1)

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