TAWAU 2010 Registration

Form
DISTRICT 87 DIVISION K 15TH SEMI-
ANNUAL CONVENTION
Date: 9TH & 10TH October 2010 Venue: Hotel Emas, Tawau,
Sabah
Website: http://tawau-2010.blogspot.com
Name _____________________________________________________________________

Toastmaster Title (CC, ACS, DTM etc):____________________________________________

Club Position (President, Secretary etc) ___________________________________________

Mobile Phone No. ____________________________________________________________

Email Address ___________________________________________

Convention Package (Please Tick):

[ ] Full Package RM150.00
[ ] Early Bird Package RM130.00 Till 15th July 2010
[ ] Fellowship Dinner RM70.00
[ ] Workshop RM50.00
[ ] Speech Contests RM50.00

Payment: RM_________________

Payment may be made via Online Transfer to Tawau Toastmasters Club CIMB Account No.
1006 000 3756 05 4. Email your payment slip to chyeewe@gmail.com or Fax to +6089-
760434

Remarks
(Please indicate here for any special observations, vegetarian etc.)

Please submit this form via

1. Email to chyeewe@gmail.com
2. Fax to +6089-760434

You may also register online at our official website at http://tawau-2010.blogspot.com.

For Group Registration please use a separate form.

Contacts:
Organising Chairperson: Rosslin Peter Rosen, ACB, CL +6016-8263978
Lee Chye Ewe +6012-8182168, chyeewe@gmail.com