International
Student
Charrette

Fields with an asterisk (*) are required.

Salutation*

Please enter salutation.

First Name *

Please enter first name.

Last Name*

Please enter last name.

Identity card/passport number *

Please enter Identity card/Passport number.

Gender*

Please select gender.

Nationality *

Please enter nationality.

Mobile Phone*

Please enter mobile phone.

Email Address *

Please enter email.

Required to receive confirmation

Password *

Please enter password.

Address 1*

Please enter address 1.

Address 2

School & Programme*

Please enter school & programme.

University *

Please enter university.

Country *

Please select country.

Emergency Contact Person

Please enter emergency contact person.

Emergency Contact Mobile Number

Please enter emergency mobile number.

T-shirt size * (View Size Guide)

Please select t-shirt size.

Diet *

Please select diet.

Kindly attach the following* • Proof of enrollment at a university / school or course (PDF format)

Please attach proof of enrollment at a university.

• CEMACS Official Program & Activity Waiver Form (PDF format)
(Download and fill up the form)

Please attach CEMACS official program & activity waiver form.

REGISTRATION FEES PER ENTRY:
MYR 350 (Malaysian Ringgit)

InternationalStudentCharrette