Participation Form
1
REGISTRATION FORM *** PLEASE WRITE CLEARLY – THANK YOU! ** Name Gender: M/F University /Organization Mailing Address: Contact No. (H/P): (Hse) I/C No. Passport No. Expired Date Email Invited by Do you have any medical conditions ? Do you have any special food requirements? Registration Fee: RM1,500 /person (excluding air fare) I enclosed herewith: (please √ for payment making) Cash for RM ________ Cheque /bank draft no. _________________ for RM ________ Cheques/bank drafts should be made payable to: Global Peace Festival Malaysia Berhad Or bank in to Maybank account # 512352317503 (fax in the duly validated Bank pay in slip) I hereby confirm the participation and the payment made. (Signature) Date: Please fax/ email the completed form latest by 10th July 2012 at (fax) 037886 2103 or (email) [email protected] or [email protected] For further enquiries kindly please contact our office at 03 – 7805 4760 Mr. Nicholas Lee (012319 3287) or Ms. Alice Cornwell (012 450 3573) International Youth Exchange (IYE) Korea 2012
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Transcript of Participation Form
REGISTRATION FORM
*** PLEASE WRITE CLEARLY – THANK YOU! **
Name Gender: M / F
University /Organization Mailing Address: Contact No. (H/P): (Hse)
I/C No. Passport No. Expired Date Email Invited by
Do you have any medical conditions ?
Do you have any special food requirements?
Registration Fee: RM1,500 /person (excluding air fare)
I enclosed herewith: (please √ for payment making) Cash for RM ________ Cheque /bank draft no. _________________ for RM ________ Cheques/bank drafts should be made payable to: Global Peace Festival Malaysia Berhad Or bank in to Maybank account # 5123-‐5231-‐7503 (fax in the duly validated Bank pay in slip) I hereby confirm the participation and the payment made. (Signature) Date: Please fax/ e-‐mail the completed form latest by 10th July 2012
at (fax) 03-‐7886 2103 or (email) [email protected] or [email protected] For further enquiries kindly please contact our office at 03 – 7805 4760 Mr. Nicholas Lee (012-‐319 3287) or Ms. Alice Cornwell (012-‐ 450 3573)
International Youth Exchange (IYE) Korea 2012
