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AL-JAZARI

INNOVATION HUB

REGISTRATION FORM

Certified Cyber Security InfoSec Analyst Industry Traning
Course Fees: RM 7500 (per pax)

Company/Organization (if applicable) : Email Address (in block letters) :

Contact Number : Website :

Full Address :

Pay by: Cheque Bank Transfer Cash HRDF

Select WE - Sat 7 Sep to Sun 21 Sep 2019 Sat 28 Sep to Sun 12 Oct 2019
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Package
Date: WD - Mon 2 Sep to Fri 6 Sep 2019 Mon 23 Sep to Fri 27 Sep 2019
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Attendee 1:
Attendee 2:

If registering 3 or more attendees, please contact us for bulk discounts. Dates and/or venues can change due to unforeseen
circumstances. For Early Bird rates, full payment must be made one week prior to course date.

Please print and email this form to: aljazari@usim.edu.my or call us on +601 499 521 43

Alternatively, please post to:
Research & Innovation Management Center (RIMC)
CONTACT PERSON:
Level 4, Chancellery Building, Universiti Sains Islam Malaysia, CONTACT PERSON:
Bandar Baru Nilai, 71800, Negeri Sembilan
Emran Huda
Emran Huda
+6014 995 2143
Payment can be made direct into our Bank account: +6014 995 2143
aljazari@usim.edu.my
Bank Islam Malaysia Berhad, Account No. : 0505 8010 0214 88 aljazari@usim.edu.my
A/C Name: Bendahari, Universiti Sains Islam Malaysia

AL-JAZARI INNOVATION HUB