2014 MSCPMP Circle HALF YEARLY Subscription Form

[New / Renew / Update] Subscriber Information Name: (As in Passport) First Name: Last Name: (Name registered with PMI) Company (current) Designation: Default is PM Correspondence address Email 1: Personal email address only Date of Birth yyyy/mm/dd Email 2: Company / personal email address PMI ID: Mobile Phone: PMP ID: PMP Trained by AsiaICTpm: Yes / No PMP Certification Date: Joined MSCPMP Circle before (please circle) : No: If Yes : 2008 / 2009 / 2010 / 2011/2012/2013 ALL fields are compulsory You may check your name registered with PMI at https://ccrs.pmi.org IMPORTANT: Email 1, Email 2 or Mobile Phone info will be used for event notification and registration If you have obtained your PMP from others, please email a copy of your passport size photo to mpc@AsiaICTpm.com. The subscription information will be used for the purposes associated with the activities conducted by the Circle, e.g. announcement of events, collection of payments and distribution of newsletters. By submitting this form, I hereby consent to the collection and use of the information as described above.

2014 MSCPMP Circle Subscription Fee One time registration fee Annual Subscription AsiaICTpm PMP Alumni RM100.00 RM300.00 Others RM200.00 RM400.00 FIRST TIME Subscriber AsiaICTpm PMP Alumni : RM100 + RM300 = RM400 PMP Trained by Others: RM200 + RM400 = RM600 Payable to MSCPMP Circle (Maybank 5-14169-15234-5) Amount: ______________________ Cash / Cheque No: _______________ Bank: ______________________ Terms and conditions: You will entitle to attend a Half Yearly Forum and one (1) additional SPECIAL EVENT free. Earning you a total of 8 PDUs. Enjoying 40% discount on all workshops organized by us.

How to make payment Direct Transfer Transfer the fund via Maybank2u.com / Maybank’s ATM machine into our Maybank account No 5-14169-15234-5 (account owner Advanced Technology Studies Center Sdn Bhd). Print PDF payment receipt and the completed registration form Email documents in (2) to us. Email: mpc@asiaictpm.com By cheque Please cross your check and make payable to MSCPMP Circle (Maybank 5-14169-15234-5) Bank in the cheque via Maybank’s ATM machine and scan or fax bank in receipt.