Graphene Malaysia 2018

Graphene Malaysia 2018 is jointly organised by NanoMalaysia Berhad and Phantoms Foundation Spain with

the support of the Ministry of Science, Technology and Innovation (MOSTI), Ministry of International Trade

and Industry (MITI), Malaysian Investment Development Authority (MIDA), and the National Graphene

Action Plan 2020 acts as the strategic partner for this event.

Date : 29 and 30 October 2018

Venue : Ministry of International Trade and Industry (MITI), Kuala Lumpur, Malaysia

Aim : The conference features plenary sessions and thematic workshops (Graphene Production /

Applications of Graphene & Related Materials/Metrology, Characterization and

Standardization/Commercialization & Industrialization) and an exhibition showcasing the

latest products, services and technology in the graphene field that attract about 200-250

participant all over the world.

Target Audience : Open for industry leaders, small and medium entrepreneurs, start-up business owners,

academicians, researchers, students and anyone in revolutionising innovations with

graphene.

Theme : Strengthening Graphene Ecosystem towards the National Agenda.

This is an individual registration form. Should you have more than one (1) participants, kindly fill in this form separately.

Full Name:

Age:Contact Number:

I would like to participate as:(Mid registration fees – Valid until 14th September 2018 only)

Local (Malaysia)

☐ Participant (MYR 1450.00 per person)☐ Student -supported by Scopus (for paper presentation) (MYR 1200.00 per person)☐ Exhibition Pass (MYR 450.00 per person)

Exhibition Package (Malaysia)

☐ Space Rental (MYR 3200.00)☐ Package 1 (MYR 3300.00)☐ Package 2 (MYR 3700.00)

International

☐ Participant (€ 480.00 per person)☐ Student-supported by Scopus (for paper presentation) (€ 360.00 per person)☐ Exhibition Pass (€ 100.00 per person)

Exhibition Package (International)

☐ Space Rental (€ 1250.00)☐ Package 1 (€ 1400.00)☐ Package 2 (€ 1650.00)

Email:

Position:

Department:

Company/Organisation/University:

Full Address:

How did you hear about the event? ☐ Social Media☐ Word of Mouth☐ Website

Payment Method: ☐ Bank Transfer ☐ ChequeSignature of authorisation:

ENQUIRIES AND REGISTRATION

Name: AmeerulOffice Tel: 03 2166 8849 ext. 111 Email: ameerul@nanomalaysia.com.myAddress: NanoMalaysia Berhad , A-2-3, Level 2,157 Hampshire Place Office, No 1, Jalan Mayang Sari,50450, Kuala Lumpur, Malaysia.

TERMS AND CONDITIONS:

PROGRAMME FEE

Account Name: NanoMalaysia BerhadRM Account No: 5644-1870-6708Bank: Malayan Banking BerhadBranch: Technology Park MalaysiaSwift: MBBEMYKLAddress: Technology Park Malaysia, 57000 Kuala Lumpur

• Fee is payable to NanoMalaysia Berhad only.• Fee includes course materials, lunch and tea breaks.• Full payment of the above amount shall be made within thirty (30) days from the date of the Payment Advice or on the day of the event, whichever earlier.• Admittance may be denied upon failure to make full payment as per the above requirement. Invoice(s) will be issued upon receiving filled registration form and proof of payment.

CANCELLATION/TRANSFER

Upon registering, participant(s) are considered successfully enrolled in the event. Should participant(s) decide to cancel/transfer their enrolment, a cancellation/transfer policy shall be applied as follows.

a. Written cancellation/transfer received less than seven (7) days from the date of the event:

- A refund (less administrative charge of 20%) will be made- Unpaid registrations will also be liable for 20% administrative charges

b. Written cancellation/no show on the day of the programme:

- No refund will be entertained- Unpaid registrations will also be liable for full payment of the registration fee- Partial cancellation is not allowed

You can substitute an alternate participant if you wish to avoid cancellation/transfer charges. Any difference in fees will be charged accordingly.

*Please select the participant classification carefully as it determines the fee payable. No alteration will be allowed after the registration is accepted. Terms and conditions apply.

DATA PROTECTION

Personal Data is gathered in accordance with the Personal Data Protection Act 2010 (Act 709).

DISCLAIMER

NanoMalaysia Berhad reserves the right to change the speaker(s), date(s) and to cancel the programme should circumstances beyond its control arise. NanoMalaysia Berhad shall not be responsible for any costs, damages or losses incurred by the participant due to the changes and/or cancellation. NanoMalaysia Berhad also reserves the right to make alternative arrangements without prior notice should it be necessary to do so. Upon signing the registration form, you are deemed to have read and accepted the terms and conditions herein.