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Course Registration Form

Course Title

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or Key in Your Own Title

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Course Start Date

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Sponsorship (*)

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Contact Person

Salutation(*)

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Name(*)

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Designation/ Department/ Division(*)

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Company(*)

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Billing Address (*)

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Street Address

(*)

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Street Address Line 2

City(*)

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State / Province(*)

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Postal / Zip Code(*)

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Telephone(*)

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Fax

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Email Address (*)

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Participant Details

Participant Salution 1

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Participant Name1

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Telephone

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Fax

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Email Address

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Dietary Requirement

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Participant Salution 2

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Participant Name2

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Designation/ Department/ Division

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Telephone

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Fax

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Email Address

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Dietary Requirement

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Participant Salution 3

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Participant Name 3

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Dietary Requirement

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Payment Method(*)

Cheque/CashGIROGEBIZCredit Term (for Approved Companies Only)Invalid Input

Cheque number

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PO Number

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Terms and Conditions

Registration

Registrations will only be confirmed upon receipt of the completed registration form and payment.

Confirmation letter and official invoice will sent once application has been approved. 
Acceptance into the course is on a first-come-first serve basis.

Payment

The course fees stated are subjected to 7% GST (applicable only to Singapore companies).

Payment of the course fee should reach AMI before course commencement. Registration will only be confirmed upon receipt of payment.

Cheque payment in Singapore dollars should be crossed 'A/C Payee Only' and made payable to 'Activemedia Innovation Pte Ltd'. Please kindly indicate the course title and date at the back of the cheque.

Cancellation by Participant*

Unless otherwise stated, if notice of withdrawal is given in writing:

" 2 weeks or more prior to the course commencement 
- Full refund 

" 2 weeks or less prior to the course commencement 
- No refund but replacement for the same course on the same date is accepted.

" After commencement/ No show 
- No refund

* Not applicable to Customized Activities

Cancellation by Activemedia 

AMI reserves the right to cancel or reschedule a course/workshop/seminar due to unforeseen circumstances. Every effort, however, will be made to inform participants of the change. Fees will be refunded in FULL, if a course is cancelled by AMI.

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