MSIG Club Select Conference
2020 Online Registration

Closing date for submissions : 15 January 2020

* Compulsory Field

Agency Details / Confirmation

Agency Name *

Servicing Branch *

RSVP *

Note: If not attending - Please select T-Shirt Size and fill in N/A for compulsory field then click Submit

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

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

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

_______________________________________________________________________

Passenger Details

Name as per Passport *

Designation In Agency *

New IC No. * (e.g. 123456-12-3456)

Nationality *

Passport No. *

Passport Expiry Date *

Address *

Gender *

Dietary Arrangements

Attach Passport Copy (PDF or JPG, Maximum size 2MB)

Note: If you do not have a valid passport, kindly email to operations@sunway.com.my before 29 February 2020

_______________________________________________________________________

Emergency Contact

Name

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

Relationship

_______________________________________________________________________

MSIG T-Shirt (Unisex)

T-Shirt Size *
(Refer to size chart below)

_______________________________________________________________________

Hotel

AccommodationTwinSingle - Surcharge RM1,090. (Subject to room availability)

Preferred RoomSmokingNon Smoking

Would you like to Extend your stay?YesNo

If Yes, please specify RETURN date (DD/MM/YYYY)

** Note: Surcharge of RM300 for flight extension and airfare surcharge (if any depending on your extension date)

Remarks if any

All the Information is kept strictly confidential and secured. Information is only gathered with your consent and only used for the purposes stated above.

Kindly double check to make sure all the information is correct before submission. For any question/changes/re-submission, please feel free to contact Lai at: (603)-5633 3446 or Email: operations@sunway.com.my

Online Form

MSIG Club Select Conference 2020 Online Registration

Agency Details / Confirmation

Passenger Details

Emergency Contact

MSIG T-Shirt (Unisex)

Hotel

MSIG Club Select Conference
2020 Online Registration