Registration Form

Download and submit this form to :-

The Secretariat (AGREX08)
Centre For Extension, Entrepreneurship & Profesional Advancement (APEEC)
Universiti Putra Malaysia
43400 Serdang
Selangor, Malaysia

Fax : +603-89466964/7236/7502 Email:agrex08@putra.upm.edu.my/agrex08@apeec.upm.edu.my

Or register online here:

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Email*
Password*
6-12 characters
Retype password*
Personal
Category

International participant/presenter
International Student
Local participant/presenter
Local Student

Designation

Prof. Dr.
Mr. Mrs. Ms.
Full name*
First name
Last name
Mailing address
including postcode
Phone
Fax
Method of payment

Cheque
Bank draft
Local Purchase Order (LPO)
Related information
   
Will you be attending Pre conference?

Yes
No
Will you be attending visit site?

Yes
No