APSC Mission and Exhibition Cambodia 2011 Registration Form

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DELEGATE REGISTRATION FORM hghghghhghghghghh DELEGATE INFORMATION (Please tick as appropriate) Salutation: Dr □ Prof □ Mr □ Mrs □ Mdm □ Ms □ □ APSC Member □ Non- APSC member As in NRIC/Passport Last Name _________________________________________ First Name _________________________ ____ Name to appear on Badge (max. of 20 characters) _______________________________________________________ Job Title / Designation__________________________ Company _________________________________________ COMPANY’S ADDRESS Street ________________________________________________________________________________________ Postal / Zip Code___________________________ Country ________________________________________ Tel (Country Code)________________________________________________________________________________ Fax (Country Code) (optional field)____________________________________________________________________ Email______________________________________ Mobile Phone (optional field)__________________________ Kindly provide the following details to us to facilitate the confirmation of your participation: Business Registration Number______________________ _______________________________________________ Corporate Write-Up plus Products/ Services offered (50 words max) In English:_______________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ CONTACT PERSON’S INFORMATION: NEXT-OF-KIN (OPTIONAL) Salutation: Dr □ Prof □ Mr □ Mrs □ Mdm □ Ms □ (please tick) Last Name________________________________________________________________________________________ First & Middle Name_________________________________________________________________________________ Tel (Country Code)_____________________________ Mobile No___________________________________ Email_____________________________________________________________________________________________ _ APSC Cambodia Education Mission and Exhibition 2011 – Registration Form Page 2
DELEGATE REGISTRATION FORM hghghghhghghghghh Which of the business meetings would you be interested in attending during the Exhibition (Please number in order of preference with 1 being the most preferred and 2 being the least preferred) Session I Business Meeting with institutions □ Session II Business Meeting with consultants □ Note: We shall, to the best of our ability, assign the business meetings of your choice to you. However, under certain circumstances, we may not be able to accede to your request for the most preferred session. We thank you for your understanding in this regards. Travel and Accommodation- International Delegates For overseas delegates that require assistance with their travel and accommodation, please contact the Secretariat at secretariat@apsc.org.sg. For further enquiries, please contact: Ms Amy Heng APSC 98 Henderson Road Singapore 159543 Tel: (65) 63708841/63517870/90174216 Fax: (65) 62561550 PAYMENT SELECTION Payment by Cheque – For Singapore Delegates Only Cheque should be made payable to ‘Association of Private Schools and Colleges Singapore’. Please mail your cheque to the Association of Private Schools and Colleges Singapore, 98 Henderson Road, Singapore 159543. Payment by Telegraphic Transfer (TT) – International Delegates TT to be made in favour of the ‘Association of Private Schools and Colleges Singapore’. APSC’s banking details for TT are as follows: Organisation Name: Association of Private Schools and Colleges Singapore Beneficiary : Association of Private Schools and Colleges Singapore Name of the Bank : United Overseas Bank King George’s Blk 803 King George’s Ave, #01-242/244Singapore 200803 Account No : 332-300-459-3 Swift Code : UOVBSGSG Bank Code : 7375 Branch Code : 332 APSC Cambodia Education Mission and Exhibition 2011 – Registration Form Page 3
Page 1: REGISTRATION FORM Jointly Organised

APSC Mission and Exhibition Cambodia 2011 Registration Form

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