Registration Form

DBS Theatrette
(6 Shenton Way, Singapore)
Monday June 17, 2002
Registration Form

The amount we will charge to your credit card is:
Single Attendee Price -- S$100 (US$55.00) per person

Please complete the form below. After typing information,
print this form and mail or fax with payment to the address below.
YOUR INFORMATION
First Name:
Last Name:
Title:
Company Name:
Street Address:
City:
State or Prov.:
Zip/Postal Code:
Country:
E-mail Address:
*Providing your e-mail address to us indicates that you may be interested in receiving future e-mail promotions about other INTM events.
Check to opt-out
Telephone:
Fax:
PAYMENT INFORMATION
Credit Card Holder's Name:
*Credit Card Type:
Credit Card Number:
Month card expires:
Year card expires:
Cancellations and Substitutions
Should you be unable to attend, please inform Serene Tay (stay@internet.com) and you can substitute another attendee at no extra charge.

We welcome a substitute delegate to take your place should you not be able to attend at the last minute. However, we regret that there will be no refunds for cancellations and no-shows.

Please Note:
INT Media Group, Inc. ("INTM") reserves the right to make changes to the events program. Unforeseen circumstances may result in the substitution of a presentation, topic or speaker. You consent to INTM recording and/or photographing the event and using such items, including your likeness, in future promotions. INTM reserves the right to reject or rescind any registration and return any fees accordingly. Registrant assumes all risks incidental to participation in all event activities, including loss or damage to property. INTM's total liability shall be limited to the amount of fees received, if any, from a particular registrant.

How did you hear about us?:
If other:
 
 

Mail your completed registration form with payment to (cheques payable to asia.internet.com LLC):

asia.internet.com LLC
Search Engine Strategies Forum Asia 2002
50B Tras Street
Singapore 078989

Faxed registrations should go to +65 274 8913 - ATT: Sunny Tan.

NOTE: REGISTRATION FORM AND PAYMENT MUST BE RECEIVED TOGETHER TO BE PROCESSED.