Download committee registration form

THE 16th ASEAN TELECOMMUNICATIONS & INFORMATION TECHNOLOGY MINISTERS MEETING(TELMIN) THE
17th ASEAN TELECOMMUNICATIONS & INFORMATION TECHNOLOGY SENIOR OFFICIALS MEETING (TELSOM) AND THE
RELATED MEETINGS
22-26 November 2016, Bandar Seri Begawan, Brunei Darussalam
COMMITTEE REGISTRATION FORM
SECTION A – IDENTITY
Please click the appropriate box below:☐
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COMMITTEE MEMBER
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Secretariat
Protocol
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Substantive
PR & Media
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Finance
HSS & Traffic
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Transport
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Logistics
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F&B
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Social
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Airport
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Other:
LIAISON OFFICER
SECURITY
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FIRE BRIGADE
PARAMEDIC
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POLICE
MEDIA
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HOTEL
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CATERING
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OTHER:
REQUIRED ACCESS TO MEETING VENUE?
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YES
NO
SECTION B – PERSONAL INFORMATION
Title:
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Mr.
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Mrs.
Ms.
Last Name:
First Name:
Date of Birth:
Gender:
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Male
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Female
Identification Card No.:
Section/Department:
Contact No.:
Fax. No.:
Email Address:
SECTION C – SUBMISSION INFORMATION
Please e-mail completed Registration Form to: [email protected] and provide us with a
copy of your identification card. Thank you.
Submitted by:
(Name & Designation)
FOR OFFICIAL USE
Received by:
(Name, Signature & Date)
Checked & Approved by:
(Name, Signature, Date & Stamp)