Old-Registration

Training Registration

For training registration, kindly fill in and submit the Training Registration Form below.

Part 1: Company Information
Name of Company *

Address *

Email*

Tel *

Fax

Part 2: Contact Information
Title*

Gender*

Contact Person Name *

Designation *

Email*

Tel*

Fax

Part 3: Training Program & Participant Information
Date*

Training Program *

1. Participant Name *

IC Number *

Contact Number *

2. Participant Name

IC Number

Contact Number

3. Participant Name

IC Number

Contact Number

4. Participant Name

IC Number

Contact Number

5. Participant Name

IC Number

Contact Number

6. Participant Name

IC Number

Contact Number

7. Participant Name

IC Number

Contact Number

8. Participant Name

IC Number

Contact Number

9. Participant Name

IC Number

Contact Number

10. Participant Name

IC Number

Contact Number

For enquiry, kindly contact:

UNIPEQ SDN BHD
Block A, UKM-MTDC Technology Centre, Universiti Kebangsaan Malaysia, 43600, Selangor, Malaysia

Tel: +603 – 8926 9184
+603 – 8920 8263
Fax: +603 – 8925 2115

Email: unipeq@ukm.edu.my