8th MALAYSIA GEOHERITAGE CONFERENCE &

6th INDONESIA-MALAYSIA JOINT GEOHERITAGE CONFERENCE

Registration Form
Salutation:

Mr

Ms

Mrs

Dr

A.Prof

Prof Others _____________

Profession: ________________________________________________________________
Organisation: _______________________________________________________________
Address:___________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_
Tel: ______________________________

Fax:_________________________________

Email: ____________________________
Options:

I would like to attend the conference

I would like to join the pre-conference field trip

I would like to present the following paper (Attach abstract)

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Note:
Please email/fax/ post this form before