8th Malaysian Road Conference 2010

Registration

Registration Form

We are delighted that you have decided to register for the 8th malaysian Road Conference 2010. You are kindly requested to read the following information before submitting your registration.

1. DELIGATE

Title:
Name of Delegate:
Preferred Name on Badge:
Position / Job Title:
Organisation:
Correspondance Address:
Postcode:
State:
Country:
Tel:	- i.e.area code-phone number
Fax:	- i.e.03-12345678
* Email:

2. TECHNICAL VISITS
Please indicate your interest to participate in the Technical Visits below:

Technical Visits:

3. SOCIAL VISITS
Please indicate your interest to participate in the Social Visits below:

Social Visits:

Social Visits (accompanying persons only):

4. POST CONFERENCE TOURS
Please indicate your interest to participate in the Post Conference Tours below:

Post Conference Tours:

5. TRAVEL COMPANION

Will you be accompanied by companion(s)?
Title:
Full Name:

6. PAYMENT

Early bird Rates - by 15 June 2010
	International Delegates	USD 350.00
	REAAA Members	USD 300.00
	REAM Members	RM 850.00
	Non REAM Members	RM 950.00
Standard Fees -(from 16 June 2010)
	International Delegates	USD400.00
	REAAA Members	USD 350.00
	REAM Members	RM 1,000.00
	Non REAM Members	RM 1,100.00

Payment by USD / RM bank draft or cheque must be made payable to 8th Malaysian Road Conference 2010. Payment can also be made by credit card. Registration will only be confirmed when the full payment is received. Please mail your payment to:

Secretariat for 8th Malaysian Road Conference
c/o Road Branch, Public Works Department, Malaysia
Block F, Level 15, Jalan Sultan Salahuddin,
50582 Kuala Lumpur, Malaysia

OR

Road Engineering Association of Malaysia
46A, Jalan Bola Tampar 13/14,
40100 Shah Alam, Selangor, Malaysia

Payment in:
Mode of payment:		Bank Draft/Cheque No:
For the sum of payable to 8th Malaysian Road Conference 2010

8. Print and Fax

You may fax the completed form to +603-5513 6523 / +603-2693 6662

8th Malaysian Road Conference - Sunway Pyramid Convention Center, 10, 11, 12 October 2010
Safer Roads - The Challenges Ahead