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 Online Courses that you would like to take: *
Required
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 when applicable) *
Your answer
Participant Email Address *
Your answer
Username (for Academy Online) *
please provide a username (no spaces) e.g. fredkugan, timboleh, or mikeaswell, etc.
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. *
Required
A copy of your responses will be emailed to the address you provided.
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