ANF Summit 2017 Delegate form

22-23 August 2017

Double Tree by Hilton Hotel Johor Bahru, Menara Landmark
12 Jalan Ngee Heng, Bandar Johor Bahru, 80000, Johor, Malaysia

Delegates form

If you are human, leave this field blank.

Given name *

Family name *

Date of birth *

Designation/Title *

Affiliation/Organization *

Contact no.

Mobile no.

Email *

Member economy *

Nationality *

Passport no. *

Passport date of issue *

Passport place of issue *

Passport date of expiry *

Flight informaiton (Arrival)

Arrival flight number

Arrival date

Arrival time

Flight informaiton (Departure)

Departure flight number

Departure date

Departure time

Bio *

Using 200-250 words, introduce yourself. Your introduction will be published in program booklet and website.

Photo *

Drop a file here or click to upload Choose File

Maximum upload size: 5MB

Upload your profile photo which we will use for inserting in program booklet and website. Make sure your photo is at least 600x600 pixels in dimension and not more than 5MB in file size.

Important notes

Accommodation

Organizer will provide accommodation for 3 nights (single room occupancy) at Double Tree By Hilton, Johor Bahru, Malaysia for 2 key members from each ANF Organization. Accommodation will include breakfast and in-room internet.
Organizer will provide 1 extra night’s accommodation (single room occupancy) at Double Tree By Hilton, Johor Bahru, Malaysia for Speakers on Nanotechnology Safety Seminar from 20 Aug 2017. Accommodation will include breakfast and in-room internet. Organizer require up to 6 speakers for the seminar.
Costs of additional nights, suite upgrades, any meals and incidents beyond the hospitality noted above should be paid by the participants directly to the hotel.
Hotel Accommodation for all other delegates @ Double Tree By Hilton, JB will be at RM 290.00 ++ (RM 338.14 nett) and for double occupancy is RM 330.00 ++ (RM 384.78 nett). As rooms are limited, it will be on a FIRST-COME FIRST-SERVE basis.

Transportation

Airport transportation will be covered by the organizer.
For arrivals – there are 4 flight under MAS Airline coming from KLIA to JB Senai Airport at 0720hrs, 1445hrs,1745hrs and 2145hrs.
For departures – JB Senai Airport to KLIA under MAS Airline, at 0630hrs,0840hrs,1605hrs and 1910hrs

Flight Itineraries

Speakers are kindly requested to book their flights to arrive Johore Bahru on 20 Aug 2017.
Participants are kindly requested to book their flights in order to arrive in Johor Bahru on 21 August 2017 and depart on 24 August 2017

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