Academy Event Registration
Please complete one form per participant.

Registration on the course will be confirmed via email. Please ensure you have a valid email.

Registration is confirmed only after full payment has been received. Please review our training terms and conditions.

Email address
Name of Course
Course Fee Categories
(Please check course information for details on discount codes and/or early bird rates)
Required
Course Fee Paid by
Title
First Name & Last Name (To be on certificate)
Your answer
Participant Email Address
Your answer
Username (for Academy Online)
please provide a username (no spaces) e.g. wildasia, fredkugan or reza_ioi
Your answer
Organisation/Company
Your answer
Current Job Designation
Your answer
Contact Telephone no. (+60xx xxx xxxx)
Your answer
Postal Address (Important for sending the certificate - please make sure all details are correct.)
Your answer
Past experiences relating to the course
Your answer
Have you attended any of the following online modules?
Dietary restrictions
General Academy Terms & Conditions
1. All bank charges will be borne by the payee.
2. All training fees are inclusive of GST fee, Admin fee, training materials, refreshments and, lunches.
3. Cancellation: in the event of cancellation, refund is subject to prior notice.
o If notice is given more than 30 days, 75% is refundable
o If notice is given more than 15 days, 50% is refundable
o 7 days or less than prior to the training date starts, no refunds
4. Please email proof of payment to training@wildasia.org for records.
5. For online payment, you can make a payment here: http://academy.wildasia.org/?p=20
6. Academy Terms and Conditions: http://academy.wildasia.org/admissions/academy-terms-conditions/

Bank Account information:
Account Name: WILD ASIA SDN BHD
Account Number: 2100 3700 0800 05
Bank Name: RHB Bank Berhad
Bank Address: Ground & 1st Floor, Lot 5, Block 27, Fajar Complex,
Jalan Mahkamah, Town Extension II,
91000 Tawau, Sabah Malaysia
Bank Swift Code: RHBBMYKL

I have read and understand the Academy terms and conditions.
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