15th MALAYSIA CHEM-E-CAR COMPETITION 2020

REGISTRATION FORM
(all registration form should be submitted to amira@iem.org.my)

EARLY BIRD : RM 300 (SUBMISSION BEFORE 21ST MARCH 2020)

NORMAL RATE : RM 350
INTERNATIONAL GROUP FEE : USD 100
Name of institution: _________________________________________________________________
Address: __________________________________________________________________________
Group Name: ______________________________________________________________________
Email Address: _____________________________________________________________________

Tick if
Name Vegetarian Phone Number
(✓)
Advisor
Team Leader
Team Members

Please TICK (✓) where applicable:

We enclose herewith a crossed cheque/bank draft issued in favour of
“The Institution of Engineers, Malaysia”.

We authorize you to debit my Visa/Mastercard

Card No. : Card Holder Name :

Expiry Date : Amount :

I/We understand that the fee is not refundable if I/we withdraw after my/our application is/are
accepted by the Organizing Committee. However, substitution of participants is allowed. If I/We
failed to attend the competition, I/We will still settle the registration fee in full. All payments must be
received by Institution Engineers Malaysia (IEM)

For further enquiry, kindly contact:

Chem-E-Car 2020 Secretariat
Chemical Engineering Technical Division
The Institution of Engineers, Malaysia
Bangunan Ingenieur,
Lots 60 & 62, Jalan 52/4, PO Box 223 Jalan Sultan
46720 Petaling Jaya, Selangor Darul Ehsan
Fax: 603-7957 7678 / Tel: 603-7968 4026 / Email: amira@iem.org.my
Facebook page: 15th Malaysia Chem-E-Car Competition 2020