MDRT Fyler.ai - Malaysian Insurance Institute
MDRT Fyler.ai - Malaysian Insurance Institute
MDRT Fyler.ai - Malaysian Insurance Institute
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REGISTRATION FORM<br />
MALAYSIA <strong>MDRT</strong> DAY 2012<br />
Erasing Boundaries<br />
PROGRAMME DETAILS<br />
Programme Date : 1 September 2012<br />
Venue : Kuala Lumpur Convention Centre<br />
Programme Schedule : 8.00 a.m. – 9.00 a.m. (Registration)<br />
9.00 a.m. – 5.00 p.m. (Seminar)<br />
Fees RM USD<br />
Before 31 May 2012 288 105<br />
1 June – 31 July 2012 388 140<br />
1 August – 1 September 2012 488 180<br />
PARTICIPANT’S DETAILS<br />
NO NAME DESIGNATION IC NUMBER<br />
1<br />
2<br />
3<br />
4<br />
5<br />
Company:<br />
Address:<br />
Telephone No: Fax No: Em<strong>ai</strong>l:<br />
PAYMENT DETAILS<br />
Amount : RM / USD<br />
Cheque / bank Draft No :<br />
Credit Card : ViSA MASTERCARD<br />
Expiry Date :<br />
Card No : Name on Card :<br />
Signature :<br />
Telegraphic Transfer<br />
Account No : 2-64160-00004670 (Ringgit Malaysia)<br />
6-14165-00000321<br />
Bank : RHB Bank Berhad<br />
Address : RHB Bank Bhd. G129, Ground Floor, Bangsar Shopping Centre, 285 Jalan Maarof, Bangsar, 59100<br />
Kuala Lumpur, Malaysia<br />
Send complete registration form to:<br />
The <strong>Malaysian</strong> <strong>Insurance</strong> <strong>Institute</strong> For more information, please contact : 03-2087 8882<br />
Life <strong>Insurance</strong> Tr<strong>ai</strong>ning Department<br />
No 5 Jalan Sri Semantan Satu Sharifah ext 151 em<strong>ai</strong>l: sharifah@mii.org.my<br />
Damansara heights, 50490 Kuala Lumpur Malina ext 152 em<strong>ai</strong>l: malina@mii.org.my<br />
Shaharidun ext 154 em<strong>ai</strong>l: ridun@mii.org.my<br />
or fax to 03-20921501
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