REGISTRATION FORM
Registration form for Integrated Management System Awareness Training on 15 - 16 October 2019.
Salutation *
First Name: *
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Last Name: *
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ID Number (for certificate purpose): *
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Organisation: *
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Address: *
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Email: *
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Phone Number: *
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Payment Method: *
Payment Details:
All payment for registration should be made payable by 14 October 2019.

Name: Malaysian Institute of Road Safety Research
Address: Lot 125 - 135, Jalan TKS 1, Taman Kajang Sentral, 43000 Kajang Selangor

Account No: 8600466624
Bank Name: CIMB Bank Berhad, Ground & 1st Floor, Block A, MKH Avenue, Jalan Avenue 1A, 43000 Kajang, Selangor
Swift Code: CIBBMYKL
Reference: IMS Training

Kindly note that seats are limited and based on first-come, first-served basis.
Inquiries:
Please do not hesitate to contact:

Rabihah Ilyas
rabihah@miros.gov.my
016 378 3003

See you there!
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