CUMaS Outreach 2014 Volunteer Survey
Hi there! Thank you for your interest in participating!

Please fill up this form to help us coordinate Outreach 2014 more effectively! We would also like to have more information on your home-town / address in Malaysia so that we can arrange outreach events closer to you for your convenience!
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First Name *
Last Name *
Email Address *
Contact Number (preferably Malaysia's)
Will you be back in Malaysia for the Summer? *
Please tick if you will be present for that month.
Required
Please indicate the most convenient location for you to attend an Outreach event.
If your home town is not listed below but you strongly believe that we should conduct it there, please indicate and we will hopefully accommodate if we have sufficient manpower! :)
Would you like to be a speaker for our Outreach events? *
What course are you doing?
This is especially important if you tick "yes" to the question above
Which weekend will you be free / most willing to attend an Outreach event? *
All dates shown below are Saturdays!
Required
Suggestions and Comments
This will help us improve this year's Outreach Programme
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