Asia Technological University Network (ATU-Net) Institutional Membership Registration Form
Please complete this form to become an institutional member in ATU-Net.
Email address *
INSTITUTION INFORMATION
Name of institution *
Your answer
Institution's official website (URL) *
Your answer
Name and designation of the Head of the Institution *
Your answer
Email of the Head of the Institution *
Your answer
CONTACT PERSON
Name *
Your answer
Email *
Your answer
Address *
Your answer
Office phone number (Please add the calling code before the phone number.) *
Your answer
Mobile phone number (Please add the calling code before the phone number.) *
Your answer
Fax number (Please add the calling code before the fax number.) *
Your answer
DECLARATION
Please confirm the following before submitting the registration form. *
Required
Universiti Teknologi Malaysia (UTM) is the Secretariat of ATU-Net. For further inquiries, please contact ATU-Net Coordinator, Dr Diana at diana@utm.my.
A copy of your responses will be emailed to the address you provided.
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