IBIA Asia 2011 Golf Challenge - Registration Form R0

							                    International Bunker Industry Association (Asia) Ltd                       Office: (65) 64720 916
                    352 Tanglin Road, #01-03 (Strathmore Block)                                Fax: (65) 64720 919
                    Tanglin Int'l Centre, Singapore 247671                                     Web: www.ibia.net


                                  IBIA Asia 2011 Golf Challenge
                                      Warren Golf and Country Club
                                        81 Choa Chu Kang Way
                                           Singapore 688263

                                     Friday, 2 September 2011

To:       Chairman, Organizing Committee

I wish to register for the abovementioned event:

IBIA MEMBER                            Number         TOTAL AMOUNT
      (i) S$1000 Per Flight                           S$
      (ii) S$250 Per Ball                             S$

Non- member
   (i) S$1,200 Per Flight                             S$
   (ii) S$300 Per Ball                                S$


Company/Organization:


Name & Title:

Phone Number:

E-Mail Address:


Signature / Date:


Please complete and return to Kwok Fook Sing, Fax (+65 64720919) or Email (fs.kwok@ibia.net) and send payment as
follows

      (a) By check: in favour of “International Bunker Industry Association (Asia) Limited ” and mail to
          “ International Bunker Industry Association (Asia) Ltd, 352 Tanglin Road, #01-03 (Strathmore
          Block), Tanglin International Centre, Spore 247671” or

      (b) By T/T: to “ International Bunker Industry Association (Asia) Limited
                   HSBC                       Account No. (SGD) 152-864104-001
                   21 Collyer Quay            Swift Code: HSBCSGSG
                   HSBC Building              Bank Code: 7232
                   Singapore 049320