Online Registration Form

Select Program & Date:

Name of Participant(s)
I/C No
Designation
?
1.
2.
3.
4.
5.
? Tick if Participant is Vegetarian.

Company Name: *
Company Address:
Contact Person: *
Designation:
Telephone: * -
Fax: * -
Your Email: *
Nature of Business:

Cheque (No: ) of RM , crossed and made payable to XcelLearn Resources.

Do you need us to assist you on the booking of hotel accommodation?
Yes      No
If yes, please specify:
Check-in Date:     Check-out Date:

* The hotel accommodation is subject to availability. Please re-confirm with the coordinator before the training and make payment directly to the hotel on the training day.

Remarks:

* - Required fields.