Registration Form_SCIC Safety Case Specialist Workshop – Human Factors (07 December 2017)


(A) Participant’s details

Company Name*
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Full Name*
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Email (Confirmation will be send to this email)*
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NRIC*
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Designation*
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Contact Number*
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Meal Type*
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(B) Invoicing details

Status*
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Attn To:*
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Billing Address*
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Billing Email*
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Billing Contact No.*
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Note:
- Please call 62678891 if you did not receive any confirmation email within 5 working days.
- Seats are on first come first serve basis and are limited.
- All registrations will be taken as confirmed and will be billed accordingly.
- Incomplete forms will not be entertained.
- NO CANCELLATIONS are allowed upon registration. No-shows will be billed. Replacement is acceptable through written notice within 7 days before the commencement of the session.
- SCIC reserves the right to change/cancel any part of the programme.
*An invoice will be sent to the company before the start of course.

- Personal Data Protection Act
Upon submitting this registration, I hereby agree and give consent to the Singapore Chemical Industry Council Limited (SCIC) to collect, use, disclose and process my personal information for one or more purposes solely for the SCIC event (insert name of the workshop/course etc), including the usage of photographs taken during the event for publications by SCIC.

Please arrange for cheque payment to be made payable to:

"Singapore Chemical Industry Council Limited"

Mail to:
Singapore Chemical Industry Council Limited
8 Jurong Town Hall Road,
#25-04, The JTC Summit
Singapore 609434
Attention: Lenie