Please fill up this form – post or email to socialismmalaysia08@gmail.com
PARTICULARS (Please write clarly in BLOCK LETTERS)
Title/Name (Ms/Mr) ……………………………………………………………………
Name on Name Tag: ……………………………..
Individual/Organisation: …………………………………………..
Postal Address (please write in the box):
Phone: …………………………………… Fax: ………………………………………..
Email: …………………………………… Mobile: …………………………………….
REGISTRATION (Does not include food, lodging and travel)(please tick)
Local Participants RM 50 ( )
Oversea Participant US$ 25 ( )
Student ( )
Unemployed ( )
OPTIONAL
Do you need us to arrange reasonable lodging & accommodation ( )
Do you need us to arrange transport from airport to venue ( )
( for overseas participant only)
REGISTRATION FORM @ PAYMENT to be send to:
Payable : PSM CENTRE
Bank – EON Bank, Brickfields Branch
Account Number : 0061-10-003237-7
To be send to :
Secretariat - SOCIALISM 2008-MALAYSIA
22A- Jalan Vivekanda,
Brickfields, 50470 Kuala Lumpur
Tel : 603-22747791
Fax: 603-87374772
Email: mailto:psmhq@tm.net.my
Website : http://parti-sosialis.org/
Comradely,
S.Arutchelvan
Secretary general
Tuesday, July 29, 2008
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