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2117 Jalan Ramin, 1.5 Mile Jalan Tuaran, Kota Kinabalu, 88400 Sabah, Malaysia Email Address: [email protected] Webpage: www.punckpogun.wordpress.com REGISTRATION FORM PROGRAM DETAIL(S) Title : Location : Date of Program : PARTICIPANT DETAIL(S) Name : Gender : Male / Female NRIC No. : Age : Mailing Address : Email Address : Contact No. : Occupation : Industry : Highest Education : Signature : Type of Participation : Self Company Sponsored COMPANY DETAIL(S) (If Company Sponsored) Company Name : Mailing Address : Contact Person : Designation : Email Address : Contact No. : Authorised Signatory : Company Stamp : PAYMENT DETAIL(S) Program Fee : Registration Fee : RM60.00 Payment Method : CHEQUE / E-BKG / CASH Full Payment : Payment Method : CHEQUE / E-BKG / CASH TERM AND CONDITION(S) 1. UPON SUBMISSION OF REGISTRATION FORM ; the participant shall remit the Registration Fee 2. UPON RECEIPT OF CONFIRMATION OF PARTICIPATION ; the participant shall remit the full payment of the Program Fee. 3. There shall be “NO REFUND” of any fee(s) for any cancellation received less than seven (7) days to the date of program; this shall also apply to “NO SHOW”. Companies may nominate replacement of participant with no extra charges. 4. Course Fee(s) shall include Training Material, Certificate and Beverages throughout the session, whichever is applicable. 5. All payments shall be payable to “PUNCAK POGUN” at RHB Bank (Bank Account No. 21007960001256), enclose copy of receipt with Registration Form.

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2117 Jalan Ramin, 1.5 Mile Jalan Tuaran, Kota Kinabalu, 88400 Sabah, MalaysiaEmail Address: [email protected] Webpage: www.punckpogun.wordpress.com

REGISTRATION FORMPROGRAM DETAIL(S)

Title :

Location : Date of Program :

PARTICIPANT DETAIL(S)

Name : Gender : Male / Female

NRIC No. : Age :

Mailing Address :

Email Address : Contact No. :

Occupation : Industry :

Highest Education :

Signature :

Type of Participation : 🗹 Self 🗹 Company Sponsored

COMPANY DETAIL(S) (If Company Sponsored)

Company Name :

Mailing Address :

Contact Person : Designation :

Email Address : Contact No. :

Authorised Signatory

: Company Stamp :

PAYMENT DETAIL(S)

Program Fee :

Registration Fee : RM60.00 Payment Method : CHEQUE / E-BKG / CASH

Full Payment : Payment Method : CHEQUE / E-BKG / CASH

TERM AND CONDITION(S)

1. UPON SUBMISSION OF REGISTRATION FORM; the participant shall remit the Registration Fee

2. UPON RECEIPT OF CONFIRMATION OF PARTICIPATION; the participant shall remit the full payment of the Program Fee.

3. There shall be “NO REFUND” of any fee(s) for any cancellation received less than seven (7) days to the date of program; this shall also apply to “NO SHOW”. Companies

may nominate replacement of participant with no extra charges.

4. Course Fee(s) shall include Training Material, Certificate and Beverages throughout the session, whichever is applicable.

5. All payments shall be payable to “PUNCAK POGUN” at RHB Bank (Bank Account No. 21007960001256), enclose copy of receipt with Registration Form.

6. Puncak Pogun reserves the right to change any details or particulars of the program whenever necessary without prior notification.

For Office Use Only:

Program Code : Invoice No. :

Ref. No. : Receipt No. :

CoP Ref. : Certificate No. :