Agency Name * (Please fill in even if not attending)

Servicing Branch *—Please choose an option—Alor SetarBatu PahatIpohJohor BahruKlangKluangKota BharuKota KinabaluKuala LumpurKuantanKuchingMelakaMiriMSIG StaffPenangPetaling JayaSandakanSerembanSungai PetaniTawau

RSVP *—Please choose an option—AttendingNot Attending - Contact your Account Handler for other arrangement

Office Tel. No. * (e.g. 03-12345678)

Mobile Tel. No. * (e.g. 012-3456789)

Email Address * (e.g. johndoe@yahoo.com)

Name as per Passport *

Designation In Agency *

Nationality *—Please choose an option—MalaysianJapaneseOthers (If others, please advise in REMARKS)

Passport No. *

Passport Expiry Date *

Gender *—Please choose an option—MaleFemale

Dietary Arrangements * (select only if applicable)—Please choose an option—N/AVegetarianPork FreeNo BeefOthers (If others, please advise in REMARKS)

Attach Passport Copy * (PDF or JPG, Maximum size 2MB)(For those attending, please upload your passport copy)

Name

Mobile Tel. No. (e.g. 012-3456789)

Relationship