DELEGATE REGISTRATION FORM (Please read notes below, before filling and dispatching the Registration Form) DELEGATE DETAILS Title* Desig. Phone (Off) Phone (Res) First Name* *City *Mobile# COMPANY DETAILS Company Address PAYMENT DETAILS Last Name* *Country *email Contact All payments towards the ‘Delegate Registration Fee’ may please be made by Cheque/Bank Transfer/Cash payment to the account of the beneficiery “KUWAIT ENGINEERS FORUM”, Account No. 0235775315100414011 with The Commercial Bank of Kuwait, Salmiya Branch, Kuwait. (IBAN: KW11COMB0000235775315100414011 ) *Cheque No. *Bank HOW TO REGISTER *Amount *Date Filled up registration forms shall be sent to one of the following email addresses. The original form along with the payment shall be handed over to our authorized member who will contact you in person within 24 hours. Email addresses: [email protected] OR [email protected] OR [email protected] OR [email protected] IMPORTANT NOTES • • • • • • The fields marked with * are mandatory. Registration cannot be processed without receiving payment of the Conference Registration fee of USD 100 or KWD 30. One registration form is required for one delegate. However, Companies sending more than three delegates may fillup only one form attached with a list of personnel with the above delegate details. No refund will be made for cancellation, however substitute delegates are allowed. Delegate Kit contains Certificate of participation, Conference proceedings in flash drive, KINETIC 2014 Journal and Satchel. Lunch and refreshments also will be provided for the Delegates. Any clarifications shall be addressed to Mr. G. Unnikrishnan,, Convener-Technical Committee, at email address [email protected] or at mobile number +96599524785.