MBAM ANNUAL

SAFETY & HEALTH CONFERENCE 2020

21st – 22nd October 2020
(Wednesday & Thursday)
8.30 AM – 5.00 PM
MBAM Sunway Hotel Resort & Spa, Petaling Jaya

REGISTRATION FORM
(Fax : 03-7982 9811 or Email: mbam13@mbam.org.my | mbam14@mbam.org.my | On/Before 9TH OCTOBER 2020 (FRI)

We wish to register the following participants:-

1. Mr/Ms _________________________________________ Designation: ______________________________________

Vegetarian?
NRIC: _________________________________________ CIDB Green Card Expiry Date: ________________________ (Please tick √)

H/P: _____________________ Email : ___________________________ JKKP Reg. No: ___________________ (if any) □ YES □ NO

2. Mr/Ms _________________________________________ Designation: ______________________________________

Vegetarian?
NRIC: _________________________________________ CIDB Green Card Expiry Date: ________________________
(Please tick √)
H/P: _____________________ Email : ___________________________ JKKP Reg. No: ___________________ (if any) □ YES □ NO

3. Mr/Ms _________________________________________ Designation: ______________________________________

Vegetarian?
NRIC: _________________________________________ CIDB Green Card Expiry Date: ________________________
(Please tick √)
H/P: _____________________ Email : ___________________________ JKKP Reg. No: ___________________ (if any) □ YES □ NO

Name of Company: _________________________________________________________________________________________

Address: _________________________________________________________________________________________________

_________________________________________________________________________________________________________

Contact Person : _________________________________________ Email : ___________________________________________

 :________________________________  :____________________________

No. of Signature &

Registration RM/Pax Total (RM)
Pax Company Stamp:

MBAM Member 600.00

Non MBAM Member 700.00

Cheque Payment:
Payment Method MASTER BUILDERS
ASSOCIATION MALAYSIA
Online Transfer Date : ____________________ Time : __________________
Account No:
Cash Deposit Date : ____________________ Time : ___________________ MAYBANK 014 114 430 810

Cheque Bank-In Date : ____________________ Time : ___________________ A copy of Bank-in Slip must be
extended to MBAM Secretariat as
proof of payment.
Cheque No : __________________________________________________

Notes:
1. NO CANCELLATION of registration and refund of fees are allowed upon receipt of this registration. However, substitute is
permitted.
2. All registrations must come with proof of payment.
3. MBAM reserves the rights to change any topics of the Conference without prior notification to participants. Due to limited seats
available, acceptance is based on first-come-first-served basis.
4. CLOSING DATE: 9TH OCTOBER 2020 (FRIDAY)