National Chamber of Commerce and Industry of Malaysia PRIVATE SECTOR’S DELEGATION TO th The 15 Malaysia-Taiwan Joint Economic Conference 10th -13th November 2014 * Taipei, Taiwan Company/Organisation: Address: Telephone: Fax: Email: Contact Person: Participants H/phone: Designation Passport No. Expiry Date 1. 2. 3. 4. [Please enclose the photocopy of 1st page of your passport and EMAIL your passport size photograph together with the registration form] Nature of Business: Business Interest: Interested in sourcing for Products / Services: Interested in selling / offering of Products / Services: Interested in seeking Joint Venture Partner: YES Please specify details: Company Profile: In a separate sheet, please give us a brief summary (within 100 words, in word format) of your company profile to be included in the delegation handbook. Flight details: 10-Nov 13-Nov MH 366 MH 367 KUL/TPE TPE/KUL 0925-1410 1510-2005 FEE STRUCTURE Air Fare: RM3,100 Business Class (airfare subject to seat confirmation) RM1,540 Economy Class Grand Hyatt Taipei 君悅大飯店 RM2,670 Room rate RM 890 per room per night with breakfast x 3 nights) Same rate for Single and Twin Sharing RM 340 Hotel: Administrations: Total Cost for Economy Class = RM4,550 Total Cost for Business Class = RM6,110 PAYMENT We herewith enclose our cheque (Cheque No.: being payment of participation fees for ) person of RM ** CHEQUES TO BE MADE PAYABLE TO “NCCIM” Authorised Signature: Name: Date: Designation: For enquiries, please contact: Ms. Poh of ACCCIM Secretariat at Tel: 03-4260 3090/ 3091, Fax: 03-4260 3080 or Email: pohwk@acccim.org.my