Workshop Registration Form
Title:
Behavior Development, Disorders and Treatment

Date:
27th November 2017 (Monday, 9.00am to 6.00pm) to
29th November 2017 (Wednesday, 9.00am to 6.00pm)

Venue:
The Settlement Hotel Melaka
No. 63, Jalan Ujong Pasir
75050 Malacca, Malaysia
Website: <https://thesettlementhotel.com/>

Contact us at +6012 301 5123 or iesymposium2015@gmail.com

Participant information
Designation *
Required
First name *
Your answer
Last name *
Your answer
Email *
Your answer
Contact number *
Your answer
Organization *
Your answer
Dietary restrictions *
Required
Workshop fee (limited to 20 participants only)
Fee inclusive of training materials, certificate of participation^ and meals (1 lunch and 2 tea breaks).

^One full day of six hours training is equivalent to 3 CEUs.

Note: You will receive an e-mail confirmation upon receipt of your completed registration and payment.

Payment details
1) For Malaysian participants, please make fee (RM) payable to:
Bank: Hong Leong Bank Berhad
Beneficiary name: IE Symposium
Account number: 02601011393

2) For Oversea participant, please make fee (SGD) payable to:
Bank: OCBC Bank
Beneficiary name: Lee Ban Meng
Account number: 511337156001
Bank code: 7339
Bank address: 23 Serangoon Central, #B2-28/29, Singapore 556083
Bank branch code: 511
Swift code: OCBCSGSG

*Please email the proof of transaction to: iesymposium2015@gmail.com

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