Important note : Please fill the registration form below only AFTER you have made payment and not before. Submission of

regisration form without payment details is not valid and no seat has been reserved. No cancellation allowed after payment.

REGISTRATION FORM

PERSONAL DETAILS

FULL NAME (AS PER IDENTITY CARD)

VENUE OF WORKSHOP  PREFERRED

HANDPHONE NO.

FULL ADDRESS INCLUDING POSTCODE AND STATE (NO P.O. BOX NUMBER AS WE CANNOT DELIVER)

IC NO. / PASSPORT NO.

AGE

EMAIL (IF NONE, FAX NO.)

SEX

HOUSE OR OFFICE TELEPHONE NUMBER

PAYMENT DETAILS

PLEASE TICK APPROPRIATE BOX

Seminar fees (Payment on or after 8 August 2010 ) 1 person RM999

Seminar fees (Payment before 8 August 2010 ) 1 person RM899

Seminar fees (Payment on or after 8 August 2010 ) 2 person or more RM899 per person

Number of person [________] x RM899 = [__________________] Total

Seminar fees (Payment before 8 August 2010 ) 2 person or more RM799 per person

Number of person [________] x RM799 = [__________________] Total

FOR REGISTRATION OF 2 OR MORE PERSON, PLEASE FILL IN NAMES OF OTHER PARTICIPANTS :

NAME NO 2.

Handphone

NAME NO 3.

Handphone

NAME NO 4.

Handphone

NAME NO 5.

Handphone

If more than 5 person, please use an additional form.

PAYMENT REFERENCE NUMBER

PAYMENT MODE :

DIRECT DEPOSIT (CASH / CHEQUE /ATM TRANSFER)

CREDIT CARD

PAYMENT DATE

ONLINE GIRO TRANSFER FROM _________________________(BANK NAME)

IF YOU WISH TO MAKE PAYMENT AT OUR OFFICE, PLEASE CALL ALAN 016-328 9010 FOR APPOINTMENT.

HOW DID YOU HEAR ABOUT US?

SPECIAL REQUEST

NEWSPAPER AD, NAME OF NEWSPAPER :_______________________________________________

FROM FRIENDS.  FRIEND'S NAME :____________________________________________________

OTHERS. PLEASE SPECIFY____________________________________________________________

Note : Please fax the completed form to 03-9010 3602. We will verify your payment details (Outstation cheques takes a longer

time to clear. Once verified, we will send you confirmation details by email (or fax, if no email). If you did not receive your

confirmation, please call Alan at 016-328 9010.

GLOBAL VISION MANAGEMENT (1205174-X)   EMAIL : alan@ebaybizsecret.com   WEBSITE : EbayBizSecret.com

7-2, JALAN TEMENGGUNG 5/9, BANDAR MAHKOTA CHERAS, 43200 CHERAS, SELANGOR. TEL / FAX 03-9010 3602