REGISTER

To express your interest to participate in the 4th ASEAN and Asia Forum, please fill in the registration form below and click “Submit”. Alternatively, you can download the registration form here and email it to register@aseanasiaforum.com or fax it directly to 6733 6217.

Download Registration Form

REGISTRANT INFORMATION

* Denotes mandatory fields

EARLY BIRD (Members): S$500 per person     EARLY BIRD (Non-Members): S$600 per person
REGULAR (Members): S$700 per person    REGULAR (Non-Members): S$800 per person

[ Group discount is available. For more information, please call us at 6734 9600 ]
Marketing Code:
Salutation*: Mr     Mrs     Mdm     Ms     Dr     Other
Family Name / Surname*
First Name*
Name to Appear on Badge*
Job Title / Designation*
Company / Organisation*
Address*
Postal Code*
Country*
Email
Office* (Country Code) (Area Code)
Mobile (Country Code) (Area Code)
Fax (Country Code) (Area Code)
Special Dietary Requirements Vegetarian     Others (please specify)


Personal Assistant / Contact Person (if different from above)
Name
Email
Tel (Country Code) (Area Code)


Where did you hear about the event?

PAYMENT

1) BY CHEQUE (Local Cheques ONLY)

Please send a crossed cheque, made payable to Singapore Institute of International Affairs, and mail it to
2 Nassim Road, Singapore 258370. Kindly write your name or company, contact details and state “4TH ASEAN & ASIA FORUM” on the back of the cheque.

2) BY CREDIT CARD, please state following details:

Card Number-
Cardholder’s Name
Card Type Visa     Mastercard     American Express
Expiry Date (mm/yy)

3) FOR GIRO / TELEGRAPHIC TRANSFER (TT), please transfer to the following:

(Please note that for Telegraphic Transfers, all local and agent Bank charges must be borne by the applicant.
To expedite your registration, please ensure that the full amount reaches us).

Beneficiary’s Name : Singapore Institute of International Affairs
Bank Name : DBS Bank Limited
Bank Address : 6 Shenton Way, DBS Building, Singapore 068809.
Bank Account No. : 065-004688-1 (SGD) SWIFT Code: DBSSSGSG

TERMS & CONDITIONS

• All registration fees must be received by 31 July 2011.
• An electronic confirmation of successful registration will be sent to participants within 2 weeks following receipt of payment.
• The organizer reserves the right to refuse attendance to any participant if payments are not made prior to the event.
• Only withdrawals made in writing before 1 July 2011 are entitled to a refund. Withdrawals received after 1 July 2011 will not be entitled to a refund. Please note that a standard 10% administration fee is applicable to all refund.
• No refunds are awarded for participant’s absence on the event day.
• Substitution of participants is permitted within the same company but notice of this must be made in writing prior to the event.
• The programme is correct at the time of printing but is subjected to change without prior notice.
• The organizer reserves the right to cancel and/or postpone the event when subjected to unforeseen circumstances
• SIIA may at any time modify these terms and conditions and participant’s continued participation in SIIA events will be conditioned upon the terms and conditions in force at the time of participant’s use.
• SIIA shall not be liable for any injury, damage, or loss occasioned by neglect or default of any company or person engaged in conveyancer, or any hotel proprietor or organization or other persons supplying services or materials in connection with the event.