Macroergonomics Workplace Assessment (MerWA)
This form will collect registration information for MerWA Training. Every session is open up from 12 to 20 pax.

The details of training are as follows:
  • Date     : 27 - 28 May 2025
  • Time    : 9:00am - 5:00pm
  • Venue  : HFEM Academy, Seri Kembangan
  • Trainer : Shalinda Shafei & Dr Dayana Hazwani
For any inquiries kindly contact
010-9051720 (HFEM office number)
Ms.Iin Adriana
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Full Name (As per I/C card) *
MyKAD / Passport No  (e.g : 881008-56-5111 with dash '-') *
Mobile number *
Email address *
Company/Organization/Persendirian *
Position/Designation *
Course Fee  (Please tick the appropriate choice). Note (1): HFEM Active member is a member who pay current year of membership fee. *
Method of payment *
Required
Payment information (Bank Details for Telegraphic/Electronic Fund Transfer)
Account Name: Human Factors and Ergonomics Society (M)
Bank and Branch: Maybank (KL Sentral Branch)
Bank Swift Code : MBBEMYKL
Account No. : 564717004441
Kindly email the transaction receipt/cheque deposit slip/bank in slip to treasurer@hfem.org within 48 hours of registration submission.

New method of payment  (E-wallet)
Touch n Go e-Wallet is available
Billing address to receive a quotation/invoice.(Applicable for those who would like to apply via company)
HR name (Person in charge) - if applicable
HR email (Person in charge) - if applicable
Thank you.
For those who submit company billing address, we will email together the course outline, trainer's profile, invoice/quotation.
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