REGISTRATION FORM

REGISTRATION FORM               

Title                        :(Dato/Datin/Prof/Assoc Prof/Dr/Sir/Mr/Ms)  

Full Name              :              

Organization         :  

Address                 :

               

Postcode               :                                  City:                                            State:

Telephone             :                                   Mobile:                                     Fax:               

E-mail                     :                                                                                       Alternate E-mail:

Paper No               :                Paper Title:

 

Category                :              

Conference as     :       Paper Presenter          Participant Only          Session Chair:       Interested         Not Interested

	Attend

 

Attend Conference:            :                                                                              

                                                                                                                                               

Name to be printed on GSE 2014 certificate:

Fees                       : Please thick/remark the check box for your chosen package.         

Package	Early Bird Before 31st   January 2014	Normal Fees After th 31st January 2014
STANDARD RATE	USD 280 (MYR 850)	USD 330 (MYR 950)
STUDENT RATE (Please email your student ID)	USD 250 (MYR 750)	USD 280 (MYR 850)

* Conference Fee comes with 1 lunch and 2 coffee breaks (2 days)
* All transaction in MYR base on 3.0 exchange rates with service charges
* Additional paper is chargeable at USD150 per paper – Please visit the website for the online payment link

* For student package, please email your Student ID for verification purpose

Payment Method:           Payment Option #1 (via Telegraphic Transfer or Direct Deposit)

Made payable to:  

Account number : 562834627354
Account name : KOKISDAR

Bank: Maybank Islamic                                 

Bank Address:No. 7 & 9, Jalan 9/9C, Seksyen 9, Bandar Baru Bangi, 43650 Bangi, Selangor             , Malaysia             

Swift code: MBISMYKL - MAYBANK ISLAMIC BERHAD   

Payment Option #2 (via Banker’s Cheque or Bank Draft)

Made payable to:  

Account number : 562834627354

Account name : KOKISDAR         

Bank: Maybank Islamic                                 

Bank Address: No. 7 & 9, Jalan 9/9C, Seksyen 9, Bandar Baru Bangi, 43650 Bangi, Selangor             , Malaysia             

Swift code:  MBISMYKL - MAYBANK ISLAMIC BERHAD   

Please mail the transaction slip or bank slip after the payment has been made to:

mail: gse.wcr@gmail.com

Please mail the registration form to:

mail: gse.wcr@gmail.com

Cancellation Policy

Substitution is allowed for registered participants. Please note that payment must be made prior to the early bird dateline above to qualify for early bird discount. Cancellation policy will be imposed if cancellation is made by:

1. Cancelation before 6 weeks of the event 100%

2. Cancellation less than 5 weeks of the event 50%

3. Cancellation less than 1 week of the event -no refund

Registration Fee Detail

Registration fee must be paid in advance of the event. Walk-in delegates, with payments will be admitted on space availability basis.

ACCOUNT INFORMATION DETAIL

Account number : 562834627354
Account name : KOKISDAR                         

Bank Address: No. 7 & 9, Jalan 9/9C, Seksyen 9, Bandar Baru Bangi, 43650 Bangi, Selangor, Malaysia                        

Swift code:  MBISMYKL - MAYBANK ISLAMIC BERHAD                   

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