REGISTRATION FOR SEM/ ATLAS.TI WORKSHOPS
FPBU ACADEMIC WORKSHOP IN CONJUNCTION WITH iLEC 2017
PERSONAL DETAILS
FIRST NAME
Your answer
LAST NAME
Your answer
IC/PASSPORT NUMBER
Your answer
ADDRESS
Your answer
PHONE NUMBER
Your answer
EMAIL ADDRESS
Your answer
COURSE REGISTRATION
(please tick ONE only)
COURSE
Required
PARTICIPANT
Required
iLEC ID (if related)
Your answer
LANGUAGE PREFERRED
THANK YOU FOR YOUR REGISTRATION. FOR ANY INQUIRIES PLEASE EMAIL US AT workshopfpbu@gmail.com
I hereby confirm that the above information given is true and correct
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