HBP SUMMER2018 REGISTRATION and PAYMENT

HBP SUMMER2018 REGISTRATION AND PAYMENT

Please fill the form below for your registration. Please follow the instruction for payment to confirm your place on the programme.
Full Name*

PrefixFirst NameLast Name
Home University/College:*

University/College

Address

CityState / Province

Postal / Zip CodeCountry
Department (Major)*
E-mail*
Phone Number

Country and Area CodePhone Number
Do you need a visa to come to Malaysia?

YesNo
Please kindly be noted that the HBP Summer 2018 organizing committee will not be responsible for your visa application. We will only provide invitation letter to facilititate your visa application.
Please let us know if you have any allergy or food restriction:
Please let us know if you have any other inquiry
T Shirt Size

S (W44xL63 cm)M (W50xL69 cm)L (W53xL72 cm)XL(W56xL74 cm)2XL(W59xL76 cm)
Please Choose one Package

Course Fee Package A USD 980 (Hotel 2 star twin sharing)Course Fee Package B USD 650 (USM Hostel, twin sharing, communal bathroom)Course Fee Package C USD 1180 (Hotel 2 star single*)Course Fee Package D USD 700 (USM Hostel, single*, communal bathroom)
Note: single* = single occupant in a twin room.
PAYMENT OF FEES

We will issue an invoice based on your package option to your email with payment instruction. Please note that IF YOU DONT NEED AN INVOICE you can make the payment by the following method:

i) Electronic Fund Transfer (EFT)

ii) Telegraphic Transfer (TT) (Note: applicant are liable for the bank charges)

Account Name: Usains Holding Sdn Bhd

Bank Name: AmBank (M) Berhad, Level 21, Menara Dion Jalan Sultan Ismail, 50250 Kuala Lumpur, Malaysia.

Account Number: 888-100-985-0380

SWIFT Code: ARBKMYKL

Once payment has been made please email to us the EFT transaction receipt or the TT form for our reference. Payment must be received by June 30th 2018 to confirm your place on the programme.
"By submitting this form, I hereby indicate that all the statement i have presented in this form are true and correct and i agree to comply with the rules and regulations of the Universiti Sains Malaysia."
Should be Empty:

HBP SUMMER2018 REGISTRATION AND PAYMENT