BRIDGING THE GAPS
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Young<br />
Members<br />
Group<br />
CIArb<br />
Malaysia<br />
REGISTRATION FORM|<br />
1st REGIONAL CONFERENCE<br />
organised by YMG CIArb (Malaysia)<br />
19 AUGUST 2016, KUALA LUMPUR<br />
A. DELEGATE INFORMATION (Please attach your business card or write in block capitals)<br />
Name :<br />
Gender : Male / Female<br />
Firm / Company :<br />
Bar Council Membership No. (if applicable) :<br />
Address :<br />
Postcode : Country :<br />
Tel (Office) :<br />
E-mail :<br />
Mobile:<br />
Fax:<br />
Industry : Designation :<br />
Special Dietary Requirement:<br />
B. PAYMENT METHOD<br />
REGISTRATION FEE (please tick)<br />
[ ] Early Bird Package – Conference &<br />
Evening Cocktails<br />
RM350.00 / £60 (only available before 28 th July<br />
2016)<br />
[ ] Conference only<br />
[ ] Conference & Evening Cocktails<br />
RM400.00 / £67<br />
RM450.00 / £75