NATIONAL HUMAN FACTORS AND ERGONOMICS SEMINAR 2019
Full Name *
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Email *
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Organisation/Company *
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Full Address (company/personal) *
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Mobile number *
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MyKad/Passport number (For certificate issuance) *
Your answer
Dietary restrictions *
For HFEM Active Member: I understand that I will have to pay RM300.00 within 48 hours upon after submitting this form
For Non HFEM Member: I understand that I will have to pay RM400.00 within 48 hours upon after submitting this form
For Student category: I understand that I will have to pay RM100.00 within 48 hours upon after submitting this form
Payment information
Receipt of deposited cheque/electronic fund transfer can be made in favor of the "CIESH EXCELLENT ACADEMY SDN. BHD." CIMB BANK BERHAD/ACCOUNT NO: 8602009619”, should be forwarded to hajar.hfem@gmail.com within 48 hours after submitting this registration form
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