ICFacsth21 26June11.pdf


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REGISTRATION FORM
Yes! Please register me for one of the two packages:

[ ] Package A

ACSTH: The 60-hour mandatory ICF ACSTH residential training program in two modules, at Genting View Resort, Genting
Highlands, Malaysia, on 21 to 26 June, 2011
Investment: Early Bird: RM 5,600, inclusive of food and lodging (twin sharing)
Normal RM 6,400, inclusive of food and lodging

[ ] Package B (complete package)

ACSTH: The 60-hour mandatory ICF ACSTH residential training program in two modules, at Genting View Resort, Genting
Highlands, Malaysia, on 21 to 26 June, 2011
Mentor coaching: 10-hour mentor coaching, including the 2 reference letters from qualified coaches
Investment: Early Bird: RM 7,000, inclusive of food and lodging (twin sharing) for the ACSTH
Normal RM 7,800, inclusive of food and lodging

Register before 21 May 2011 for Early Bird discounts
Contact us for group discounts

Name:(Dr/Mr./Mrs./Ms):
Full Address:
Email:
Tel:
Mobile:
If this is a corporate registration:
Approving Manager:
Title:

Email:

Company/Organization:
Address:
Email:

Tel:

PAYMENT DETAILS:

Please make cheque payable to HRD Gateway Sdn Bhd and mail to us, or bank payment into
Account Name: HRD Gateway Sdn Bhd
Bank Name: Malayan Banking Berhad, Wisma Sime Darby Branch, Kuala Lumpur
Account No: 514299128474
Bank Key/Number: 2714299
Swift Code: MBBEMYKL
CANCELLATION: A service charge of RM 785 will be levied for cancellation of registrations. However,
participant is welcome at no extra charge if you are unable to attend the program you have registered for.

Mailing address : HRD Gateway Sdn Bhd, A2-03-04, Kempas A2,
Genting View Resort, 69000, Genting Highlands, Malaysia
Tel.: +6-03-61005992; +6-03-23811060; +6-019-2268987
Email: kelly@gklim.com ; azura@hrdgateway.com, Website: www.gklim.com
Creative Consultant : Prof. (Dr.) Sudhi Ranjan Dey

Pic source: 123rf.com

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