TALK EVENT REGISTRATION FORM
Wisdom Inspired Supportive Endeavour (1189480-V)
Title of Talk: BENEFICIENT SUSPICIONS – A Novel Approach to Chronic Diseases
Date & Time: Saturday, 12 August 2017, 8pm-10pm
Email address *
Basic Information
Full Name *
(Please type your family name in UPPERCASE)
Your answer
Phone No. *
Your answer
Personal Information
Gender *
Date of birth
Your answer
Address
Your answer
Occupation
Your answer
Other Information
How did you come to know about this event? *
Your answer
What motivated you to want to attend this event? *
Your answer
May we ADD your email address to our mailing list, so that you will receive event updates? *
Additional Message, if any
Your answer
The Gift of Wisdom
Dear Participant,

Following your registration for this event, you will be receiving a gift of education — a gift of wisdom, if you may — the opportunity to learn more about how the mind (and life) works and in the process transform how you view and live your life.

This event that you are participating in has been made possible by sponsors and is freely offered to anyone who is willing to receive the gift. This is the commitment of the supporters and members of Wisdom Inspired Supportive Endeavour (WISE) who have provided the initial seed funding enabling this to happen.

WISE as a charitable non-profit, set-up to give the gift of wisdom, is in the midst of applying for permission from the authorities (Companies Commission of Malaysia) to collect donations from the public. Without this permission, only members of WISE can contribute financially (donate) to it, which they did, creating the seed funding we are benefitting from today. The WISE team is made up of mostly volunteers who offer their time to manage WISE and its events and they do not receive any remuneration from WISE. If you too are inspired to support WISE in its endeavour in any way, perhaps even in kind, please contact the program manager of the event you are attending or contact WISE directly.

By registering to participate in this event, you have indicated your commitment to learn with an open mind. If for some reason, after registering, you find that you are unable to attend, kindly let us know as soon as you can, prior to the start of the event.

May this gift of wisdom support you in your personal growth.

All the best from,
The WISE Team
http://wise.foundation/

Declaration
I hereby declare that the information provided myself in this form is true and accurate to the best of my knowledge. If at any time my circumstances change, I will inform WISE. I am willing to abide by the advice of the Speaker and the rules and regulations of Wisdom Inspired Supportive Endeavour (WISE). I shall not hold WISE and/or the Speaker responsible or liable for any mental or physical injury or distress incurred or arising during or after attending this event.

I understand that the acceptance of my participation in this event is at the discretion of WISE or the Speaker at all times. If, in the opinion of WISE or the Speaker, I am unable to continue to participate productively in this event, I may be asked to leave.

In the event that I am accepted but unable to attend, I will inform WISE of this as soon as possible.

Submission
By submitting this online registration form, or signing on a printed version, I hereby agree to the terms and conditions for the registration and participation of this event. I also give consent to WISE to process and use my personal data in the manner as permitted by law and as stated in WISE's privacy policy in accordance to the Personal Data Protection Act 2010. (A copy of WISE's privacy policy notice can be found at http://www.wise.foundation/pdpa-notice )
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms