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Company / Organisation
T h e t a E d g e B e r h a d Please visit
www.inforisk-360.com
for further information on
P.O. Box or Street Address Condition Zebra event and training
B a n g u n a n C P e r e m b a S q u a r e
S e c t i o n U 2 PAYMENT OPTIONS:
City State Malaysia Ringgit Cheque or Demand Draft
Payable to Condition Zebra (M) Sdn. Bhd.
S h a h A l a m S e l a n g o r
Electronic Transfer in Malaysia Ringgit to:
Country Zip / Postal Code
Condition Zebra (M) Sdn. Bhd.
Bank details will be provided on the invoice.
M a l a y s i a 4 0 1 5 0
MasterCard
Mobile Number Office Telephone
Visa
0 1 6 2 3 3 6 5 6 7 (Credit Card Payment will be in
Malaysia Ringgit only.)
E-mail Address
REFUND DEADLINE: Cancellations must be
d z a f i r @ t h e t a - e d g e . c o m submitted to this office and postmarked 3 working
days before the workshop.
Note: Minimum charge of RM499 will be charged to participant who fails to turn up for the workshop after confirmation of attendance. Security Code
Authorisation
Signatory must be authorized to sign on behalf of contracting organization. Exp. Date
Name: Signature
Cancellation Policy
Signature:
All information contained herein is correct at time of printing
Company Stamp (Oct 2014) and is subject to changes without prior notice.