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Page 1: PENANG INTERNATIONAL - mbam.org.mymbam.org.my/wp-content/uploads/2019/05/PICC-Brochure-Form-FA.pdf · :_____ :_____ Signature & Company Stamp: CATEGORIES RM/Pax No. of Pax Total (RM)
Page 2: PENANG INTERNATIONAL - mbam.org.mymbam.org.my/wp-content/uploads/2019/05/PICC-Brochure-Form-FA.pdf · :_____ :_____ Signature & Company Stamp: CATEGORIES RM/Pax No. of Pax Total (RM)

REGISTRATION FORM (Fax : 03-7982 9811 or Email: [email protected] | [email protected] ) PMBBMDA Email : [email protected] (Ms Kate )

COMPANY DETAILS

Name of Company :__________________________________________________________________________________

Address: __________________________________________________________________________________________

__________________________________________________________________________________________________

Contact Person : _____________________________________ Email : ________________________________________

:____________________ :___________________ Signature & Company Stamp:

CATEGORIES RM/PaxNo. of

PaxTotal (RM)

With CIDB Green Card 450.00

Without CIDB Green Card 550.00

TOTAL

Fees are inclusive of 6% Service Tax Cheque Payment or cash bank in:MASTER BUILDERS ASSOCIATION MALAYSIAAccount No: MAYBANK 014 114 430 810 A copy of Bank-in Slip (Cash/Cheque) must be extended to MBAM Secretariat as proof of payment.

Notes: 1) NO CANCELLATION of registration and refund of

fees are allowed upon receipt of thisregistration. However, substitute is permitted.

2) MBAM reserves the rights to change any topicsof the Seminar without prior notification toparticipants. Due to limited seats available,acceptance is based on first-come-first-servedbasis.

REGISTRATION

We wish to register the followings par ticipants:-

1. Mr/Ms __________________________________________ Designation: ____________________________________

NRIC: _______________________________________ CIDB Green Card Expiry Date: __________________________

Tel or H/P No: _________________________________ Email : ______________________________________________

JKKP Reg. No: _______________________________________________________________________________(if any)

2. Mr/Ms __________________________________________ Designation: ____________________________________

NRIC: _______________________________________ CIDB Green Card Expiry Date: __________________________

Tel or H/P No: _________________________________ Email : ______________________________________________

JKKP Reg. No: _______________________________________________________________________________(if any)

3. Mr/Ms __________________________________________ Designation: ____________________________________

NRIC: _______________________________________ CIDB Green Card Expiry Date: __________________________

Tel or H/P No: _________________________________ Email : ______________________________________________

JKKP Reg. No: _______________________________________________________________________________(if any)

The Top Penang, 1, Jalan Penang, George Town, 10000 George Town, Pulau Pinang

PENANG INTERNATIONAL

CONSTRUCTION CONFERENCE

2019 - SAFETY & INNOVATION18TH - 19TH JULY 2019 (THURS & FRI)

Supported by::

MBAM

Endorsed by:

PMBBMDA

Penang State Government