Workshop Registration Form
Behavior Development, Disorders and Treatment

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

The Settlement Hotel Melaka
No. 63, Jalan Ujong Pasir
75050 Malacca, Malaysia
Website: <>

Contact us at +6012 301 5123 or

Participant information
Designation *
First name *
Your answer
Last name *
Your answer
Email *
Your answer
Contact number *
Your answer
Organization *
Your answer
Dietary restrictions *
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:

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