Shop – ATAS

ICTA 2022 REGISTRATION FORM

PARTICIPANT’S INFORMATION

Full Name(Required)

First Last

Email(Required)

Phone(Required)

Organisation

Designation

Fax No.

ICTA2022 Post-conference Cultural Tour

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

REGISTRATION FEE

Event Type

Early Bird

(Before 1 May 2022)

After Early Bird

(After 1 May 2022)

Online Participants

MYR 400 (USD 100)

MYR 600 (USD 150)

Physical Participants

MYR 800

MYR 1000

Upload your Bank Receipt or Cheque Note:(Required)

Max. file size: 10 MB.

BANK DETAIL

Pay to: Malaysian Invention and Design Society
Bank name: Malayan Banking Berhad
Location: Jalan Tun Razak, Kuala Lumpur
Account no: 5-14057-636861
SWIFT code: MBBEMYKL

CONTACT US:

TEL: +603 7118 2064/66 (Mr Azman / Ms Kitty)
Email: minds.secretariat@gmail.com
Address: C-3A-10, Block C, Damansara Intan, No. 1, Jalan SS 20/27, 47400, Petaling Jaya, Selangor, Malaysia

Terms and Conditions(Required)

I agree

a. Use a separate form for each participant. Photocopies of this Form can also be used. Payments can be combined for more than one participant when forms are sent in together.
b. Registration is not official and complete until full payment is received by the ICTA2022 Secretariat. Confirmation of registration will be issued upon receipt of full payment.

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ATAS Corporate Membership Form

Section A - Particulars of Applicant

Name of Organisation(Required)

Telephone

Handphone(Required)

Email(Required)

Company Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Nominated Individual Member

Position in the Company

Field of Interest

Upload your picture

Accepted file types: jpg, Max. file size: 1 MB.

Section B - Membership Fee and Payment

Corporate Membership Entrance fees RM1000: Annual Subscription fees RM300 = Total RM 1300
1. Bank Name: MAYBANK
2. Bank Payee Name: PERSATUAN AKADEMI SAINS PERTANIAN TROPIKA (ATAS)
3. Account Number: 564191582178
4. Please Email Proof of Payment to atas.exco@gmail.com

Payment Method

CHEQUE

CASH

Online Transfer

ATAS Life Membership Form

Section A - Particulars of Applicant

Full Name(Required)

Email(Required)

Handphone(Required)

I.C. No(Required)

Gender(Required)

Marital Status

Academic Qualification(Required)

Occupation(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name

Position in the Company

Field of Interest

Upload your picture

Accepted file types: jpg, Max. file size: 1 MB.

Section B - Membership Fee and Payment

Life Membership Entrance fees RM100: One-time Subscription fees RM400 = Total RM 500
1. Bank Name: MAYBANK
2. Bank Payee Name: PERSATUAN AKADEMI SAINS PERTANIAN TROPIKA (ATAS)
3. Account Number: 564191582178
4. Please Email Proof of Payment to atas.exco@gmail.com

Payment Method

CHEQUE

CASH

Online Transfer

I agree to the privacy policy.

By signing and submitting this application, I hereby agree to abide to all Rules & Regulations and Code of Ethics as laid out by ATAS. I also consent ATAS to use all information submitted as deemed appropriate.

ATAS Ordinary Membership Form

Section A - Particulars of Applicant

Full Name(Required)

Email(Required)

Handphone(Required)

I.C. No(Required)

Gender(Required)

Marital Status

Academic Qualification(Required)

Occupation(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name

Position in the Company

Field of Interest

Upload your picture

Accepted file types: jpg, Max. file size: 1 MB.

Section B - Membership Fee and Payment

Ordinary Membership Entrance fees RM100: Annual Subscription fees RM50 = Total RM 150
1. Bank Name: MAYBANK
2. Bank Payee Name: PERSATUAN AKADEMI SAINS PERTANIAN TROPIKA (ATAS)
3. Account Number: 564191582178
4. Please Email Proof of Payment to atas.exco@gmail.com

Payment Method

CHEQUE

CASH

Online Transfer

I agree to the privacy policy.

By signing and submitting this application, I hereby agree to abide to all Rules & Regulations and Code of Ethics as laid out by ATAS. I also consent ATAS to use all information submitted as deemed appropriate.

ATAS Student Membership Form

Section A - Particulars of Applicant

Full Name(Required)

Email(Required)

Handphone(Required)

Upload your picture

Accepted file types: jpg, Max. file size: 1 MB.

I.C. No(Required)

Gender(Required)

Field of Interest

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Section B - Membership Fee and Payment

Student Membership Entrance fees RM50: Annual Subscription fees RM20 = Total RM 70
1. Bank Name: MAYBANK
2. Bank Payee Name: PERSATUAN AKADEMI SAINS PERTANIAN TROPIKA (ATAS)
3. Account Number: 564191582178
4. Please Email Proof of Payment to atas.exco@gmail.com

Payment Method

CHEQUE

CASH

Online Transfer

I agree to the privacy policy.

By signing and submitting this application, I hereby agree to abide to all Rules & Regulations and Code of Ethics as laid out by ATAS. I also consent ATAS to use all information submitted as deemed appropriate.