CONFIRMATION SLIP by j3I65T4w

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                                                                                         DEADLINE: 1 APRIL 2011
                                               REGISTRATION FORM

                                           SHOWCASE MALAYSIA 2011
                                             DHAKA, BANGLADESH
                                               10 - 12 JUNE 2011
(Please fax completed form & post original copy of form and cheque to Chemical Based Products / South Asia Unit,5 flr,
East Wing, Menara MATRADE, Jln Khidmat Usaha, 50480 Kuala Lumpur, fax no : 6203 7289)

                                             DETAILS OF COMPANY
Name of Company (in block letters):
____________________________________________________________________________________
Address: ___________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Tel: ____________________          Fax: _______________________ E-mail: _______________________
Website: _________________________________ MATRADE Registration No.: _________________
Contact Person: ______________________________________________________________________
Designation: _________________________________________________________________________

Ownership: (a) Local: Bumiputera: _______ %, Non-Bumi: _______ % (b) Foreign: _______ %
*Small and Medium Enterprises (SMEs) Status (kindly ):                   SME                 Non-SME
*Note: Definition of SMEs for services sector is having an annual sales turnover not exceeding
      RM5 million (based on the latest financial report) or not more than 50 full-time employees.
Company’s Profile (in LESS THAN 70 WORDS only) will be used for write up in promotional booklet:

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Note: Please use attachment if necessary.

Company’s Business Interest (in LESS THAN 70 WORDS only) will be used for business meeting
arrangement

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Note: Please use attachment if necessary.
          1.     Please enclose 2 copies of brochures or description of products to be promoted and send
NOTE:            softcopy file to sahibul@matrade.gov.my for show directory
================================================================================
I have enclosed a non-refundable, crossed cheque payable to “KETUA EKSEKUTIF MATRADE” of
RM6,500.00 as participation fee. Please note that the participation fee is non refundable upon confirmation
of your participation by MATRADE.

Cheque Number:____________             Bank:_________________________                Amount: RM____________

I hereby declare that the information contained in this form is true and correct and confirm to participate in
Showcase Malaysia 2011 to be held in Dhaka, Bangladesh from 10 – 12 June 2011

Name: ______________________________                          Company: ___________________________

Designation: _________________________                        Company Stamp:

Signature: ___________________________

Date: _______________________________

								
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