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SEMINAR & HANDS-ON SESSION ON UNDERSTANDING CEMENT FOR ENGINEERING APPLICATIONS
3RD DECEMBER 2019 SACC CONVENTION CENTRE, SHAH ALAM, SELANGOR, MALAYSIA
REGISTRATION FORM To register your attendance for this seminar, please use a BLACK pen to complete this form in Block
Letters and then return this page to SIRIM STS by fax (+603-5510 8830) or by email
(azwamiza@sirim.my, baizura@sirim.my, zalehat@sirim.my). 1 Person per registration form.
Photocopy this form for multiple registrations
Name :
Identification/Passport No :
Position :
Name of Company/ Organization/ University
:
Division :
Department :
Address :
:
State :
Postcode :
Country :
Tel :
Mobile :
Fax :
Email :
Mode of Payment :
Signature :
Date :
C O N C R E T E
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