REGISTRATION FORM TILAPIA 2007 KUALALUMPUR
DELEGATE INFORMATION
  Delegate
  Surname First Name Middle Name
Spouse
  Surname First Name Middle Name
Designation
Company
Address Line 1
  Line 2
City
Post Code
State/Province
Country
Tel
Fax
E-mail
BUSINESS CATEGORIES: (please tick accordingly)
   
Exporter Importer
Processor Aquaculturist / Farmer
Wholesaler Feed Manufacturer
Acadamic Hatchery Operator
Broker / Supplier Consultant
Governement Service
International Organisation Other (Please specify)
REGISTRATION FEE : (please tick accordingly and calculate the Total)
     
  Before 23 June After 23 June
Member Countries * US $ 375 US $ 475
Other Countries US $ 500 US $ 600
Accompanying Spouse US $150 US $ 200
Total US$
* Bangladesh, Cambodia, India, Indonesia, Iran, DPR Korea, Malaysia, Maldives, Pakistan, Papua New Guinea, Philippines, Solomon Islands, Sri Lanka and Thailand.
Payment Details
Mode of Payment :
A bank draft drawn on a U.S bank payable to 'INFOFISH'
Charge my credit card
Card type:
AMEX       MASTER  VISA
Cardholder's name:
Card No:
Expiry Date:

Telegraphic transfer to :

 

INFOFISH A/c No: 0-111659-028.
Citibank Bhd, Menara Citibank
165 Jalan Ampang,
50450 Kuala Lumpur, Malaysia,swift code citimykl
(Note: If your banker is remitting payment on your behalf, please give specific instructions to indicate name and
address of remitter)