FORM GTF

FORM
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GLOBAL
TRANSFORMATION
FORUM
Operclio ns lising
Tro
nsformolio n
Shifting Diologue to Effective Action
Kuolc Lumpur, Moloysio
21 -23 October 20]5
Hosted by
ffi
{ffi'l;lr'.;n,
qq;*tc
Govemment of Malaysia
Organi:ed by
BTT?*
BIS TAST RESULTS
INSTITUTS
ln Partnership with
OELEGATE INFORMATION
DIFTARY
REQUIREMENTS ,
I
Dletary Requirements: No Dietary Requirements
l{ Others. Please Specify (Dietary)
A) EARLY BIRD REGISTRATION
FEES (On
,
I
Vegetarian
l-l
Others
n
or before30 June.2015)
NOTE:
7///////////////ln
a) *Mu5t be supported by
Un;Yersily L?cturerAtudent
card or other docummtary
prwi.
b) **For gtoup registration,
please iil! up the'Group
Registralion Form' with all
delegates' particulars.
Prites guoted ar€ tax
exclusive. Tha Organiser
reserves th€ right to
charge any Govemm€nt
taxes {where applicable},
B) STANDARD REGISTRATION FEES (After
i
July 2015 Onward)
NOTE:
'//////l//////l/l/tr//
a) *Mu5t be supported by
Universiiy Lecturer6tudent
card or other documenlary
proof.
b) *'For grcup registration,
please iill up the '6roup
Registration Form' with all
delegateJ particulars.
Prkes quoted are tax
exdusive. The Organiser
ros€rYes the right to
charge any Government
taxes {whera applicabl*}'
€f//l/////y//V//l///////V/'/////
TERMS AND CONDITIONS OT REGISTRATION
7////1ff//////////////////////////
l.
il.
ksgirtrationEntidement
1. Upon payment of registration feel delegates can attend the GTF 2015 Opening
Ceremony, CoffgdTea breakt Lund and gain accesgto the exhibition, they are also
entitled to a delegate bag and other rehted materials.
2. Fffs fgr a.commodation, iliglrt5 and tours are NOI lncluded in the registration fees.
unlorereen d(umstanrer r€quire guch action, ln the special chcurhJtaffer that the entire
event has to be crn€elled, the OrganisE will refund the regisration f€ to the i€tLtranG.
Howeyst the Organisr will not be liablergr othsrassoriated cosit €.9. a(ommodaticn
and trayelling exp€nser, and any inconvrniem€, incurred to the RegistrrnB due to the
cancellation" Ih6!*rorq Regirtran* are advised to arrdnge for thek wn trard irsumnc.
1. Reginrants can register via online tegiskation at
Alternatively, they may complete the regittration rorm.and lend it to the
Seffetariat*egistration Team via efiail at 6TF20'l56globaftranrformation..om or tax
(60!) 4257 I 133.
2. Online registralion i3 open till 14 Octaber 20 1 5 only. Atter 14 Octobsr 2O1 5, registration tlL
posted on the official webllte. Plea* conta( the GTF 2015 Seretarlat via &mail at
CTf?01 Soglobaltransformation.com o. by fax to (603) 4257 1 133, if you have any
queri€s aboul the disclosura of personal inf6rmation and privacy policy.
R€sist,arionprn,,sandpayment
w,globaltraosformation.corn.
6TF
2015'
on q. befoc 30 June
4, A letter confirm,ng the reglttration will ba rent via email upon {ull payment of
fees, flease trring along thir confirmrtion
and present it atthe regiSration
when eolleting your delegate badge 6n 20 & e.l October
;*,:H:j;H;,fJ*iilli'lix1[fr{',"i,]['Jfil1[t]iffi;i,::il#mffi"
to
leglrtrdtlon Transfer
reEistration
lfier
r0l5.
regirkationf6$canbemadeyia:
i. Credit Card (Vi* & Ma*erCard only)
ii, Telegraphic Transler
w. Can.ellaiion and Refund Polltles
'l.Allcancellationof regiitrdtionmustbedoneinlr.ritingandsubmittedtothafiF20Is
se(relariat vir email at GE2o'I5€globaliraBlomation.rom or fai to (503) 4257 1 133,
Any can(ellati$os received on or be{arc 15 Septemb.r 2015 will be charged a handling
fee of MYR 105 {USD 30). The balarKe otthe regiitration te$ will be refund€d after
dedu$ing other related JieJ and (hnrgss incurred in connedion with su(h re{undt
includicg co:3 of foreign exchange convenion Credit Crrd cBncellation and/tr banking
tiansaction. Any (nn(ellations after 15 September 20! 5 \eill not be efunded.
3. Atl refundr wlll be made in MYR atthe prevailing loreign exchanga rate.
4, Refund tor (ancallations will be mad! wlthin three monlf aftsr thc confrnalion o,
2.
on,y)
iii. Local Order (Appli€ble to Malaysian Goyarnment Agencies
iv. Cheque tAppli(abls lo Malayiia'r cheque
6. For paymcnt made by Local Order (10), pfease mail the original (opy of the LO
Orde.) to the
:0J 5 tecretaiat {or veritieation before 2 October 2015. To enjoy
Sird Rates, pleam send the original L0 on or belore 30 June
7. For paynents made by Credit Card, the atount r€{led€d in l.he Gedit Card
fit
rom.
munter
5. Paymentof
only)
or fax to 6At) 4257 1133, ThB new Regirtrant rhould (omplete the regirtration
Transfer o{ r€gistration will not be allowed after 25 Srptember 2015.
(Ltral
tarly
statemst
2015.
amount pnld will be re{lecled in MYR and UsD terms.
Univenity Lectur€n and Students, to rompletethe registration, a letter or any
dtrumentary prcf &m the rElsatrt depadn€nt or learning institutlon 5hould be submittsd
to {onfirm the Lectuer or student status. The document should be sent t{, the GTF Z0l 5
Secretariat via smail at GIF20lSaglobaltransformation,(om or fax to (603) 4257 1133,
9. lh€ Organiser reJerues the righl and will infom Regisr:nts on any aheration lo any af
the arrang€men8 lor the GIF 201 5 including the cancellation of the event should
8. For
ixuem will be bome by
v,
l}e
Regbtran15,
Liability
1. Th€ Organiser rese&es the right to make changes where deemed necesk.y. with or
without prior notice to partig sn.ern€d. All dispuies are subjqted to the Malayrian law,
We kindly aJk you to authorise us by your signature to u5e all registration dat. giyen ln
this {orm for computerited handling of the tonfereme.
7////t///l////t//////////////////
LETTER OF INVITATION
(for Visa Application)
7//////////V/1/////1//////////
7//////////////////////#////l//////
PAYMENT MODE
7Z//////////////////////////
All payments should be made payable ro "GtoSALTRANSr0RMATION roRuM 2015".
0PTION 1: CREDITCARD
I hereby authorise AoS Conventionr & Events Sdn Bhd
The total amount due in
cartr No:
to (harge my Credit Card for:
MYR--.**-Type
nnnnnnnnflnnilnnX
of Card: MasterCard
t*p.oate,
[I[[
t]
visa
fl
Name on card
(MMYY) secure code
(cwcvs,
IIf]
OPTION 2: TELEGRAPHIC TRANSFER
Swift bank transfer must be made without charges to the beneficiary. and payable to "GLOBAL TRANSFORMATION FORUM 2015" in Malaysian Ringgit (MYR)
or it5 equivalent.
Name of Bank: Standard Chartered Bank Malaysia Berhad
Address
Account No
Swift Code
: Z. Jalan Ampang 50450 Kuala Lumpur, Malaysia
:3121 9461 6256
: SCBIM-YK-XXXX
lmportant Nate:
Please inrlude a copy of your bank tran:fer with your form, Bank dra{ts and cheques (excapt for loeal rlreque) will not be accepted for payment
Bank €harges are to be borne by the payee.
.
.
OPTION 3: LOCAL ORDER (Only Applicable
Please mail
the original copy of the
No. Pesa.ran Kerajaan
(Uo):
LO
to the Global Transformation Forum 201 5 Secretariat for verification.
_*. -,, Amount (MYR): ,...,-.-,,....
OPTION 4: CHEQUE (Only Applicable
Please attach the cheque or copy
for Malaydan Government Agencies)
for Malaysian Cheques)
of cheque deposit slip wltflogf,fqrnh
in
;1.
"
1.
?u.pore of
noti.e
,, IuJua, fyotls
Governmeni of Malaysia and the GTF
Z0 l 5
are
se(retariat ("Organi5eri" or "we")
Kerajaan Malaysia dan Sekretariat GTf 2Al5 {'Pengadjur' atau "kani.J dikehenda*i
the meaning a! prescribed ir the Aat,
2. Procerring of p.6onal data
The pesonal data proce$ed by u5 may include. but is not limit8d to, your aame,
lC number, address and other conta(t details.
3, Purpoi€ of pro(€ssing personal data
The personal data i5 colleded fqr, amongrt oihert the follovring purposes:
(a) to proress your registr*lion lorm for training eyents (in(luding confurences)
organired by GTF 2015 secretiri3i and collaborat've partne.{!) lor adminbtratiye
purpose such a5 attendance litt, issuan(e of invoice, officirl receipt and certifi(ate of
attendance;
(b) to communicate with you on the (oniirmation of tha eventi and matter in
{onne{tion to 6ff 20'l 5 Secretarlat events 6nd Forumi
(clto :€nd gut ema'h for ou, future tonfarences or workshops which may be related
to you;
(d) ta mail the 6ifi(i.l re(eipt and c$tifi(ate ol aitendance;
(el to respond your enquiries or complainx$ and
(f) other administrative purposes whith is related to the above"
4. Disclxure ol pertonal data
The Fe.sonal data held by us shall be kept coniidential, However. we may disclose
your personal deta to:
{a} Co{rganiser within the GTF 20'15 Secretailat;
(b) To ou. collaborative oartn€r, (ln termi ol name for irsuan(e of (ertificates
attendan(e under paragraph 3(a) above);
sf
(clOther parties authorised by youj
(d) Regulatory and gowrnmental agen(iss aJ permitted or requlred by law, authorised
by any order of court or to tr€et obligationr to regulatory authorities.
5.
Potxtion of pemBl data
The security of your pesonal data is enrured by the OrganiJeri o, GTF 20 1 5 as we shall
take all physical, techoical and organirational measur8s fleeded to earure tha security and
confideniia,ity ofyour personal dala. Ifwe disrlole any ofyour per$onal dati to any
other entitie5, we will require them to appropriatBly sa{eguard thr peasoal data
provided to them.
6, Retenlion of periooal data
It is our policy to retain your peronal data from the date of collection lor as l*ng as lt is
nece:sary lor the fulfilment of the purposes as se1 out under paragraph 3 abow or for
the comp{idnce with the law or any legal obligation of the 6TF 201 5 Secretariat. we
shall stop preressing your ddta when you write to us using th€ rontrct detaib below to
withdraw your (onsent.
7.
A(ces, of personal data
under the PDP,{ you have the right to a(cers youa personal data to enrure that the
peEonai data we hold about you i; accuratq (ompletq not misle:ding and up-to-date,
lf you wish to exercise such rights and raquert ac(s55 to your perlonal data, please
contact u5. the GTF 2015 Secreiariat or BfR lnstitute sdfi, thd, a!
6TF 2Ot5 Secr€tarist
BfR lnstitute Sdn. Ehd,
6TFl015@globaltranrformation.(om
Phone: +603 -4252 9100
rax i,603 - 4257 I 133
Fax: +603
E:
E: GTF20I
Seglobaltranr{ormotion,rom
Phone: +603 - 8872 7237
- 8872 7?90
2, Pem prosesan data pedbadi
Data peribadi anda yang diprases ol"h kaei temaJu& tetal tida& ter&ad &epada, nama,
nombor kad pengena lan alamat dan maUumat hubungan lain.
3. Taiuan mffiprotes data peribadi
Oata p*ribadi ydng diambil *dalah bagi, ,ntara lain, unlut turrilan 5eflkut
{a) unfJk dremprose, boGogpendafta ran prcgram latihan (temasuk persidangan) yang
dianjurkan cleh Sekretariat 6lF20I5 dan rakan kedasamanya untul( fujoan
pentadbiran seperti senarai kehadina pengeluaran inrcis rcsit rani dan sijil kehadiraa(b) untuk b"*o{hunikasi dengrfi anda mergcfiai pengsJahd tt aela ini dan s€barang
perkara yang berkaitan dengan Sekretaiat GTF 20'l 5, acara dan pe*dangan.
(.)untuk menghantar mel bagi persidaagan atau beng&6.l akan datang yang mungkin
frglibatkan anda;
{d} untuk penghantafan reJaf t.arrni dan juga siil kehadiftn melalai poE
{e} untuk memberi msklum balas kepada .pa-apa pertanyaan atau penEadaan;
tqapa-apa tujuan pentadbiran lain yang berkaitafi dengan pe*ata di atas,
4.
Pendedahaa Data Psrbadi
oata pedbadt yaag disifipan oleh kami akail driimpan recara sulit Walaa bagaimaoapun,
kami mungkin akan mend€dahr(an data peribadi anda kqpada.'
(albadan-badan penganiur be/'rma di dalam S"kret riat GTF 2At5;
(b) kepada
lain yang menganju*an GTf 20t 5 berl€,ma (dad segi na$a p€se{ta
"ntitiantiti
unlu& pengsrua,.an
tiiil kehadirao seperti yang dinyatakaa dalam perenggan 3{b} di atas}
(c)pihak lain yang anda benarkan;
(d) Agensi penguatkuasa dzn kelalaan sepertimana yang dibsnal&an atau drkehendaki
orrr? undang-undaf,g, dibenarkan oleh mana-mana p"rlntah tnaltkamah atau unluk
rlemenuhi obrlgaJi *epada mana-mana piha* penguatkuara.
5. Perlindangan data p€ribadi
Xeselrmatan datt peflbadianda adalah dijamin oleh Penganjur fiTF 2015 kerana kami
akan mengambil semua langkah fitrkal, tsknikal dan arganisast yang diperlakan bagi
memajfikan keJeramatan dan keahJaan data pefibadi anda. ,eloi"n/a &ami merdedahr{an
data petibadi anda kepada.nana-fiana pihala kami akan m€masti&an bah;wa prhak
tenebut metrgaf,iil /angkalr yang sepatuln/a bagi m€fiaJidon &ese/amafarr data pedlar/i
yang diberl kepada mereka.
6, Penyimpanaa data peribadi
laftya frerupakan po{isi kami untuk menyimpan data peribadi rnda drri tarikh d*ta
dikumpul sxlama ia psrlu bdgi nematuhi tuiuaa 5epetti y.ng dinyafakan di bawah
p"renggan 3 di atas atau mengikut keperluan undang-undang ataa obligasi undangilndang SekGtarlat Gff 20t 5. Kami akan rnenghentikan pempros€.ran dat per/badi
ardr, qpabila aoda mengernu&;kan perm,ntaan Jcca.a Ae.!u{is kepada kami nelalui
fiauugrat perhubungan dibawah unlu& menan* baii& *ebenaran anda.
kepada datap€ribadi
mempwyai hak ufttuk /n?ngakJe' daf€ penbrdi ,nda untuk memartrk n
data yang kaini simpan mengenai anda adalah tep;l lergr<a& tida& menyelereng dan
te/ki.r?'. Jik*srda i($ii..reng9una&an lEr( lsiebuadil ire{nofron akjes&@ada dataperibadi
anda, Jila hrburgj.$ekret;fl'at 6fF20t5 atau gFfi /n5aitute Sdn, Blrd. di a/amat dibarai:
7. A&5es
Dt b,)wah PDP& tlnda
GIFror.tSe(et rfrt
6Tf201'@globalijansformdtion.can
E:
9ra0
Na. Fak: +6Q3 - 4257 1133
/Vo.
Iel*fbn'
+503 - 4251
8fR ,rstifule Sdn- &rd6; 6fF20r5@gioba,ltrantfatmalian.ton
avo. Te/etonr +6s3 * &872 7237
No. Fakt: *6A3 * 8872 7290
",////////////////////////////////
Kindly sign and acknowledge the Declaration Statement helow after you have read and understood the Notice and you <onsent to the processing ol your
personal data by Organisers of GTt 2015 and the GTf 2015 se(retariat.
Sila tandatangafi Penyata Deklarari di bawall.retelah anda telah membaca dan menaharni Notis ini dan anda m?ngizinkan pemproieran data peribadi
anda aleh pihak Pengaojur GTF 201 5 dan Sekretariat GTF 2Al 5.
To / Kepada: BrR lnstitute Sdn. Bhd.
that I have read and understood this Personal Data Protection Notice on persona' data and by signing this, I consent to the
proce5ling of my personal data in accordance with the terms of this notice.
I hereby acknowledge
ini menyatakan bahawa saya telah membaca dan memahami Notis Pertindungan Data Peribadi berkenaan dat: perlbadi
nartdat*ngaai deklarasi ini, saya me.ngizktka/r pemprosesan dala penbadi saya se/ari dengan terma-terma nolis in,'.
5aya dengan
ute
da
D dengan
Name I Nama:
l/C No. / Passport No. / lYo. lC
I Na. Pasport:
Please return this forrn
to;
GTf 2015 Secretariat-Registration Team
c/o AOS Conventlons & Events Sdn Bhd
No. 39 & 40, Jalan Mamanda 9, Ampang
Point,58000 Ampang. Kuala Lumpur,Malaysia.
Date / Iarlkh:
Email: GTF201 [email protected]
Phone: +603 - 4252 9i00
5ignature I
Ta
ndata ngan
:
ENQUIRIE5
For enquiries, pIea5e conta(t u5 at: [email protected]
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fax:+503-4257 1133