Registration Form

Registration to the Conference can be made via this website or using this registration form. Please complete and return this form, together with your payment, to:

Secretariat

Tamil Internet 2001

<Address & contact nos. - phone & fax.>

Identification

Please complete this section accurately; the information you provide will allow us to correspond with you efficiently, and will also be used on your delegate badge at the Conference.

Title [Prof./Dr./Mr./Mrs./Ms.] …………………………………………………………….

First name ………………………………………………………………………………...

Last name …………………………………………………………………………………

Position ……………………………………………………………………………………

Organisation ………………………………………………………………………………

Tel ………………………………………………………………………………………….

Fax …………………………………………………………………………………………

Address ……………………………………………………………………………………

………………………………………………………………………………………………

City …………………………………………………………………………………………

Post code/Zip ……………………………………………………………………………..

Country ……………………………………………………………………………………

E-mail ……………………………………………………………………………………...

Registration Fees

Delegate: [ ] RM350 ; Teacher1: [ ] RM200 ; Student2: [ ] RM100

1Letter of verification required

2Valid student card required

Fees for Delegate and Teacher include: Conference kit, light refreshments and lunch. Fees for Student include: Conference kit and light refreshments.

Payment

Please ensure that your fully completed registration from is sent together with your payment. Please make cheques or bank drafts payable to Tamil Internet 2001, <address>.

Sent cheque/bank draft number ……………………………………………………….

Bank ……………………………………………………………………………………….