Registration Forms and Fee Structure

Registration FormTo:Sekitar Synergy Sdn BhdEmail: sekitar5221@gmail.comTel: 019-7725676 or 07-2441221Kindly register us for this training;(Please Select Course with X sign) Training-1 24– 25 August 2015 Environmental Quality (Scheduled Wastes) Regulations 2005 – Compliance in Practice Training-2 27– 28 August 2015 Environmental Quality (Clean Air) Regulations 2014 – Compliance in PracticeVenue: BEST WESTERN HOTEL PETALING JAYA, No. 1, Jalan 13/1, Section 13, 46100 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Telephone: (603) 7610 2222 GPS - LAT: 3.111183421201753 LONG: 101.63908079698945Company name:______________________________________________________________Company address:____________________________________________________________Contact person’s full name:__________________________Designation:__________________Contact person’s email address: (1)__________________________ (2)___________________Contact person’s Tel No.___________________ Handphone No. ________________________List of participants’ name in full;1)______________________________________________________________________2)______________________________________________________________________3)______________________________________________________________________4)______________________________________________________________________5)______________________________________________________________________Training Fee for each course:1 person: RM1700.002 – 5 persons: RM1500.00 per pax More than 5 persons: RM1000.00 per pax HRDF Claimable: Claimable under PSMB Registration Serial No. 449236ACPD hours (DOE): Each Course entitle for 12 hours. DOE-EiMAS Reference: AS91/110/600/005/2 SK.219 Jld.35 (3) & (4) dated 29 Jun 2015We are obliged to process registration and issue an invoice accordingly.