Ergolympic Registration Form

Ergolympic Registration Form

Ergolympic Registration Form
Team Leader Name
Full Name Please
Organization / University Name
Phone Number
Example: 0123456789
Email Address
example@example.com
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Team Member 1 Name (Team Leader)
Team Member 2 Name
Team Member 3 Name
Team Member 4 Name
Name of Product / Innovation / Project

Rules & Regulations
Please download and read the rules and regulation.

Payment Details
Sub-theme
Category
Registration Fee's Category
Total Fee (RM)
Total Fee (USD)
Payment Method
Banking Details
Account Name: Human Factors and Ergonomic Society Malaysia

Bank and Branch: Maybank (KL Sentral Branch)
Bank Swift Code: MBBEMYKL

Account No.: 562807604407

For internationals please use these payment links.

K1: Secondary School / High School

https://buy.stripe.com/00w5kDg1wcCieNl8jTbII0c

K2: Pre-University / TVET / Diploma /Polytechnic / Undergraduate /Bachelor Degree / Postgraduate /Researcher

https://buy.stripe.com/4gMcN55mSbyefRpcA9bII0d

K3: Professional / Industry / Startup / SME

https://buy.stripe.com/dRm5kDaHc9q6eNl43DbII0b
Upload Proof of Payment (Stripe/Bank Transfer/Guarantee Letter)

Cancelof
Payment Status
Memo
Should be Empty: