REGISTRATION FORM

CRANFIELD ASIA EXECUTIVE LEADERSHIP PROGRAMME LEADING VALUE CREATION: STRATEGIC INNOVATION AND FINANCIAL LEADERSHIP 1 5 – 1 7 O C T 2 0 1 2 , H I L T O N P E T A L I N G J A Y A RE GIST R AT I ON First Name H O T E L , M A L A Y S I A FO R M Last Name Company /Organization Position Address Country Tel Fax PostCode/Zipcode Mobile Email Website Please enter your organisational type; Manufacturer Trade Consulate Importer/Exporter Trade Association/Chamber ICT / Telco Investor Distributor Banking/Financial Institution Logistic/ Wholesale Media Retailer Professional/Businessman Government Institution Embassy Oil & Gas Agriculture Healthcare/ Pharmaceutical Others (please specify) Meal Preference Vegetarian Non Vegetarian Programme Fees Programme Fees : RM 5000 Per Participant (For Malaysian Delegates) USD 2000 Per Participant (For International Delegates) This registration includes : · Attendance at the Cranfield Asia Executive Leadership Program · Buffet lunch and refreshments each day of the Program · All learning materials that are handed out during the Program · Welcome networking dinner Payment Details Cross Cheque Payable to : K-PINTAR SDN BHD Bank : CIMB BANK, LUCKY GARDEN BANGSAR, KL Account No Swift Code (International) : CIBBMYKL : 1422-00000-38108 Do You Need Accomodation / Airport Transfer Yes / No. If Yes please contact the organiser for the arrangements. Local Participants Participants are allowed to claim for airfare and daily allowances for 3 days inclusive of the day before the conference (HRDF Contributors). You can bank in the payment to above account and email the registration form to – CAELP@k-pintar.my or fax it to +603 2284 4175 together with the copy of your bank-in-slip. International Participants You can register at www.k-pintar.my/academy/cranfield, or fax to : +603 2284 4175 together with the copy of your telegraphic transfer document. Terms And Conditions 1. 2. 3. 4. 5. 6. Registration fee inclusive of lunch, refreshment and conference materials. Registration fee does not include accommodation. Registration will not be processed until full payment made or your cheque is cleared. Substitution or cancellation is only allowed before you receive the confirmation letter and must be made in writing, via mail or fax before 30th September 2012. Any changes later than the date will not be entertained. Conference Attire – Business Casual Accommodation – Hotel arrangements and reservation can be made through program organizer. Post/Fax it to : K-PINTAR SDN BHD Suite C-13-6 13th Floor Wisma Goshen Plaza Pantai Tel : +603 22844148 Fax: +603 22844175 REGI ST NOWER 59200 Kuala Lumpur Malaysia Or register online at www.k-pintar.my/academy/cranfield before 30th September 2012. For enquiry, please email us at CAELP@k-pintar.my