SIAFC REGISTRATION FORM

Welcome to the Fundamental Social Impact Assessment Course!

We're excited that you're considering joining us for this valuable learning opportunity.

This course will equip you with essential principles and practical skills in social impact assessment.

Fundamental Social Impact Assessment Course: Principles & Practices

10-11 December 2024 (Tuesday & Wednesday)

Kuala Lumpur

Before completing this form, participants are advised to take note of the following:

Registration Fees

Early Bird (for payment received before or on 15th November 2024)
- Student: RM650
- Pensioner: RM700
- Academic Staff, NGOs, Government Agencies: RM750
- Professional, SMEs, : RM800
Normal fee (for payment received after 15th November 2024)
- Student: RM700
- Academic Staff, NGOs, Government Agencies:: RM800
- Professional, SMEs: RM850
Note: For Student, please attach proof of your student status along with this submission

Payment Information

Please make payment to the following account:

Payable To : Institut Sultan Iskandar
Bank Name : CIMB Bank Berhad
Branch : UTM, Skudai.
Bank Address : Bangunan Hal Ehwal Pelajar, Universiti
Teknologi Malaysia, 81300 Skudai, Johor.
Account No : 80-0605659-9
SWIFT Code : CIBBMYKL

Note:
- Please remarks the payment as 'SIAFC' when making a payment and ensure that payment receipt are uploaded along with this submission
- For International Participant, if you are making payment via telegraphic transfers, bank charges are to be borne by the participant.
Inquiry

Email : secretariat@susdep.com or isijb@utm.my

WhatsApp : 017 311 6146 (9.00 am - 4.00 pm, Monday - Friday)
Participant Information
Participant Category*

MalaysianInternational
How many participant to register?*

1 only2 and above
Name*

SalutationFirst NameLast Name
E-mail*
Please use a valid e-mail address
Phone Number *
Mobile Phone with WhatsApp Application
Designation / Occupation*
Type N/A if not applicable
Company Name and Address*
Type N/A if not applicable
Education Level*

PhDMastersBachelor DegreeDiplomaOthers
Education Background*
Example: Architecture, Engineering....
Professional Certification (if applicable)
Example: MBOT, BEM...
For registrations more than 1 participant, kindly furnish a comprehensive list of details for all your members in this space.
format: Full Name, Designation, Phone Number and E-mail
Registration Information
Registration Category & Fee (Early Bird)*

Student - Fee: RM650Academic Staff (IPTs, IPTS, Colleges, Polytechnics) - Fee: RM750Government Agencies - Fee: RM750Small Medium Enterprises (SMEs) - Fee: RM750Non Profit Organization (NGO) - Fee: RM750Professional- Fee: RM800Pensioner - Fee: RM700
Please upload the proof of student status from your IPT

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Payment Information
Please select one of the following options

I'd like to register and complete my payment nowI'd like to register and please send the invoice to my emailI'd like to register (using Letter of Undertaking)
Payment Information

Please make payment to the following account:

Payable To : Institut Sultan Iskandar
Bank Name : CIMB Bank Berhad
Branch : UTM, Skudai.
Bank Address : Bangunan Hal Ehwal Pelajar, Universiti
Teknologi Malaysia, 81300 Skudai, Johor.
Account No : 80-0605659-9
SWIFT Code : CIBBMYKL

Note: Please remarks the payment as 'SIAFC' when making a payment and ensure that payment receipt are uploaded along with this submission
Upload proof of payment

Browse Files

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Terms and Conditions
- Institut Sultan Iskandar reserves the right to change the venue, facilitator, and reschedule or cancel the webinar whenever deemed necessary. We shall inform participant(s) if any changes arise.
- Institut Sultan Iskandar also reserves the right to make alternative arrangements without prior notice should it be necessary to do so.
- During the seminar/course there will be a photographer/videographer onsite taking seminar-related photos and video that will be used for promotional materials for organizer (Institut Sultan Iskandar)
- Upon submitting the registration form, you are deemed to have read and accepted the terms and conditions.
Inquiry

Email : secretariat@susdep.com or isijb@utm.my

WhatsApp : 017 311 6146 (9.00 am - 4.00 pm, Monday - Friday)
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Participant Information

Registration Information

Payment Information