Registration Form
Name *
Designation
Prof.   Assoc. Prof.   Dr.   Mr.   Mrs.   Ms.
Organization
Mailing Address *
Phone : *
Fax :
Email : *
IFM Membership No. :
Title of paper
I will be attending the conference as:
Oral / Poster Presenter **    Participant   Sponsor / Exhibitor  ** All accepted contributions will be presented either orally or as posters
Registration Fees :
Early Bird Registration	After 15 June 2012
RM 700.00 - IFM Member   RM 800.00 - Non-IFM Member   RM 600.00 - Student	RM 800.00 - IFM Member   RM 900.00 - Non-IFM Member   RM 700.00 - Student
Payment
Cross Cheque   Purchase Order    Bank Draft  * Payment can be made as cross cheque, purchase order, bank draft payable to: Bendahari UKM
Cheque/Bank Draft/Purchase Order No. :
Date
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