<p> Registration Form MEET THE MEMBERS Wednesday, 16th November 2016 Venue : Cornerstone, Wisma Selangor Dredging, Jalan Ampang, Kuala Lumpur</p><p>Company Name of Company Rep. Designation Email Contact Number (Office) (H/P) Fax Address </p><p>REGISTRATION OF PARTICIPANTS FOR November 2016 MEET THE MEMBERS</p><p>Fees : Members RM 75*/ pax Non-members RM100*/pax *Include GST</p><p>No. Name Designation Direct Number Email</p><p>1</p><p>2</p><p>3</p><p>Please email the registration form to [email protected] or fax it to 03-2181 8784 before 11th November 2016, Friday. </p><p>Payment Details:  Payable to : Account name: The Malaysian Oil & Gas Services Council Bank: CIMB Account No: 800-10-40-556 Swift code: CIBBMYKL Bank branch address: CIMB Berhad, Lot G35, Concourse floor, Petronas Twin Tower, KLCC, Jalan Ampang, 50088, Kuala Lumpur. *payment to be made before/by 12 th November 2016 (Friday). *Strictly No “CASH DEPOSIT MACHINE / PERSONAL ONLINE TRANSFER”.  Please email a scanned copy of your cheque deposit slip or online payment receipt to [email protected] or fax it to 03-2181 8784. *Failure to comply and submit proof of payment will be consider as unsuccessful registration</p><p>Billing Address for Invoicing </p><p>Attention to Designation Email Contact Number Fax Address </p><p>Term & Conditions:</p><p>______AUTHORIZED REPRESENTATIVE </p><p>Date: ______</p><p>-Thank you-</p>