Register Form
Please fill out the form below and we will get back to you as early as possible.
COURSE TITLE *
LOCATION *
COURSE DATE *
MM
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DD
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YYYY
Registration Fees
* Payment of the registration fee will be inclusive of implementation 6% ST (NO. REG ST : W10-1809-32000472)
* Contact us, for more limited special offer (+6012 210 1462)
Registration *
Payment Method
Column 1
Cheque
Direct Deposit
Payment Detail
HRDF Claimable Payable to : My SHEQA Group Sdn Bhd

- Pay to : OCBC Bank Malaysia
- For Credit of : My SHEQA Group Sdn Bhd
- Account No : 7011522965

Please read carefully the Rules & Regulation prior to completing this form. If you have received this form without the Term and Conditions, please contact the Training Provider. Please sent prove payment to finance sales@mysheqa.com
Applicant's Information
NAME *
Participant Name
IDENTIFICATION NUMBER *
Identification Card
HP/PHONE NO *
Participant Mobile No
EMAIL *
Participant Email
DESIGNATION *
Participant Designation
Applicant's Information
Please skip this section if only more than one participant
NAME
Participant Name
IDENTIFICATION NUMBER
Identification Card
HP/PHONE NO
Participant Mobile No
EMAIL
Participant Email
DESIGNATION
Participant Designation
Sponsors Information
Column 1
Self - Sponsored
Company Sponsored
Company Name *
Mailing Address *
Person In - Charge *
Hp/Phone No *
Designation *
EMAIL *
Rules & Regulations
■ Registration of participants will be confirmed upon receipt of full payment or an acceptable employers guarantee and settlement of previous outstanding dues.
■ My SHEQA Group Sdn Bhd will only issue a Certificate of Attendance to those participants who registered and attend all sessions.
■ A promotional discount/discount cannot be used in conjunction with any other offer or discount

Payment Notice
■ Payment shall be made within 14 days from the date of invoice.
■ Complete payment must be received prior to the beginning of the course. Failing receipt of payment, MYSGSB reserves the right to either deny access to the class or with hold the course certificate.

Disclaimer
■ The Training Provider reserves the right to change the speaker, date, venue or to cancel the event If number of participants is less than 20. A minimum one (1) week notice will be given.

Replacements
■ Please notify us at least 14 days prior to the event if you intend to send a replacement.

Registration Deadline & Late Registration Fee
■ All registrations must be received no later than 14 days prior to the course start date.
■ Late registrations will be accommodated, provided : seats are available

Confirmation of Registration
■ The confirmation letter will be emailed 14 days before the commencement of the event upon receipt of full payment. In the event that you do not receive the confirmation letter 14 days before the event, please contact us immediately.

Cancellation Policy
■ MYSGSB must receive cancellations in writing 14 days prior to the event date. Refund amount is subject to deduction of administration and finance charges with total of 10,6 from the training fees. No refund will be given for cancellations received within less than 14 days prior to the event date.
■ Failure to attend the course without prior notice (No-Show) will result in the loss of the course fee paid or 10% cancellation fee will be charge
■ 10% from training fee will be charge for any cancellation received within less than 14 days prior to the even date
AUTHORIZATION
I am an authorized representative of the company with full power and authority to sign and deliver this application form. The company listed on this application and form agrees to comply with all the policies, rules and regulations contained on the reverse of this form, and all policies, rules and regulations adopted by the Training Provider from time to time.
Name *
Designation *
Date *
MM
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DD
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YYYY
Official Stamp Company *
Required
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