Registration Form

5th Global Islamic Microfinance Forum

November 24 – 25, 2015 at Kuala Lumpur - Malaysia

Post Event Training Workshop on Shariah Foundation, Sustainable Operational Strategies and Innovation – Conception to Practices
November 26 – 27, 2015 at Kuala Lumpur - Malaysia

Please complete and return by e-mail, regular mail or fax.

Please note that the name and title you give here will be printed on participants’ list and on certificates.

1. Participant Information

Title______£ Prof. £ Dr. £ Other: ______£ Mr. £ Ms. £ Mrs.

First name______

Last name______

Organization ______Designation ______

Address______

Postal/Zip code______City: ______

Country: ______

Telephone: ______

Fax: ______E-mail:______

Event you wish to join (Conference/ Workshop): ______

2. Conference Fee
Conference fees include admission to conference sessions, tea/coffee, lunch, registration materials and Certificate.
Event Name / Fee for Pakistani(PKR) / Fee for Int’l (USD)
Conference Fee (November 24 – 25, 2015) / Rs. 55,000 (2 Days) / $1495 (2 Days)
Workshop Fee (November 26 – 27, 2015) / Rs. 40,000 (2 Days) / $995 (2 Days)
Conference + Workshop / Rs. 95,000 (4 Days) / $ 2490 (4 Days)

3. Discount Policy

v  Five or more delegates from the same organization - 20% discount

v  Early Bird discount -20% before 1st October, 2015.

4. Account details form payment

You can proceed your fee by cheque or demand draft in favour of AlHuda CIBE or you can also transfer your fee online/wire transfer. Banks detail is as under:

For International Participants ( Dollar Account )
Account Title: ALHUDA CIBE FZ LLE
AED A/C No: 0228 – 088619 – 001
Bank Name: Emirates Islamic Bank, Dubai, U.A.E
IBAN: AE49 0340 0002 2808 8619 001
Swift Code: MEBLAEAD
For Pakistan’s Participants.
Account Title: Al Huda
Account A/C#: 0204 – 0100430195
Bank Name: Meezan Bank Ltd
Branch Address: Garden Town Branch, Lahore, Punjab – Pakistan
Bank Swift Code: MEZNPKKA

** Please state the conference name and the full name of the participant on the reverse of the cheque.

Payments should be made in Pakistani rupees or in Dollars.

5. Additional Instructions

v  Payment Information Registration forms must be accompanied by full payment in order to be processed.

v  Full payment is due on registration

v  Registration will not be confirmed until full payment has received

v  Confirmation Please allow 3 days for e-mail confirmation of your registration.

v  We do not have any cancellation policy. If you are unable to attend, you may substitute another individual in your place at no extra charge.

By sending in this registration form, I acknowledge that I commit myself to the immediate payment of the full conference fee. I have taken notice of the cancellation terms on this form.

Date: _____/_____/______

Signature: ______

Return address:

AlHuda CIBE FZ LLE - U.A.E AlHuda CIBE (Pvt.) Ltd. - Pakistan

(Advisory, Consulting & Capacity Building) 160-B, 1st Floor, Ahmed Block,

P.O. Box. 120867, Dubai - U.A.E New Garden Town, Lahore - Pakistan.

Ph: +971 4818 7226, +971 56 928 6664 Ph: +92 42 3591 3096-8

Fax: +971 4818 7280 Fax: +92 42 3591 3056

E-mail: Web: www.alhudacibe.com

2