Conference Registration

Date: 4th June 2013
Venue: Empire Hotel and Country Club

Full Name*
Name to appear on Tag
Position
Organisation
Address
Street AddressCityState / Province / RegionZip / Postal CodeCountry
Phone*
Fax
Email*
REGISTRATION FEE PER EVENT
Rates*
- Normal Rate @ B$325
- Early Bird Rate* @ B$250
- Group Registration (5 and above) per organisation @ B$250 Each
* Early bird rates end on 3rd May 2013
PAYMENT METHODS
I would like to pay by*
- Credit Card
- Bank Transfer
- Cheque
Credit card type
- VISA
- Mastercard
Credit card number
Name of card holder
Expiry date
Transfer to: 'Asia Inc Forum Sdn Bhd'
HSBC A/C No: 001-020924-001

Please fax us the stamped pay in slip as proof of payment together with details of who the payment is for.
Cheques made payable to 'Asia Inc Forum Sdn Bhd'.
Cheques can be delivered to:
ASIA INC FORUM SDN BHD, NO.6 REGENT SQUARE SPG 150, KIULAP, BANDAR SERI BEGAWAN BE1518, BRUNEI DARUSSALAM.
Notes: Registration fee is non-refundable, but is transferable to another person.
Registration closes on: 31st May 2013.
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REGISTRATION FEE PER EVENT