1. REGISTRATION & WORKSHOP SELECTION MAFa & IAF MALAYSIA CHAPTER 3 RD COUNTRY CONFERENCE NURTURING THE SEEDS OF FACILITATION IN THE INDIVIDUAL, ORGANISATION & COMMUNITY

2. REGISTRATION – please complete the workshop selection on the next page 1.Name __________________________________ Designation: ______________ 2.Name __________________________________ Designation: ______________ 3.Name __________________________________ Designation: ______________ 4.Organisation: _____________________________________________________ _________________________________________________________________ 5.Contact email: _____________________________________________________ 6.Mobile No. ______________________________Office: ____________________ 7.Contact Person: ____________________________________________________ 8.MAFa / IAF Member: YES / NO (please circle) 9.Workshop Presenter: YES / NO 10.Please TICK the appropriate category PUBLIC & NON-MAFa /IAF MEMBERS  CORPORATE SINGLE/ EXPATRIATE: RM 1350/- (USD 360)  EARLY BIRD SIGN UP BEFORE 30 APRIL: RM 950 /- (USD 260)  CORPORATE GROUP (3 OR MORE) RM 950 PER PAX MAFa & IAF MEMBERS  MAFA NEW MEMBER: RM 800/- (Membership 2015 RM 120/- inclusive)  EXISTING MAFa & IAF Members RM 680 /- (USD 200)  WORKSHOP PRESENTER SPECIAL ENTRY  FACILITATORS DINNER ON 25 MAY (OPTIONAL) RM 68 PER PAX / USD 20 TOTAL PAYMENT : RM ___________ BY CHEQUE /TT / ONLINE BANK TRANSFER TO : MALAYSIAN ASSOCIATION OF FACILITATORS MAYBANK WISMA CONSPLANT ACCT. NO. 562302611389 SWIFT CODE: MBBEMYKL for overseas payment Enquiries : mafaregister@gmail.com Civil Society Organisations, NGOs and Students may write in for preferential discounts which may be granted depending on key criteria. Contact mobile Grace at 0122732747 Seats only reserved upon payment. Kindly retain your bank in slip as an entry ticket. Receipts issued at the door The Organizers reserve the right to make changes due to unavoidable circumstances. No refunds upon cancellations, replacements are welcome

3. Workshop Selections NAMESERIES A A 1- A 4 SERIES B B 1 – B 5 SERIES C C 1 – C 3 1 2 3 For your workshop choices please fill in your name and the Number and Title of the Workshop chosen for each of the Series A, B or C. You can only chose one workshop from each series. You may add another line if there are more than 3 participants from your group SUGGESTIONS FOR ACCOMMODATION : http://www.damas-suites.com/contact-us.phphttp://www.damas-suites.com/contact-us.php PLAZA DAMAS SUITES & RESIDENCES These links connect to apartment suites and residences closest to the conference venue out of the major traffic flow for the area, and 10 min. drive away from the Kiara Equestrian & Country Club. You may book on your own using www.agoda.com or www.booking.com whichever you are most comfortable with.www.agoda.com www.booking.com Bookings are your responsibility and you are free to source for other accommodation that is more suited to your needs. FACILITATORS’ DINNER ON 25 MAY 2015 You are welcome to join the Facilitators’ Dinner at the halal Chinese restaurant The Oriental Pearl at the conference venue from 6.30 pm. Dinner will be a halal Chinese menu. It will be a networking opportunity with the Organisers and Workshop & Plenary Lead Facilitators.