Delegates Registration Form

Delegates Registration Form

PARTICIPANT REGISTRATION FORM
Reference No. / / Official Use Only / 20 September 2018
GLOBAL FOOD SECURITY CONFERENCE
“YOUTH STEP UP TO ACHIEVE FOOD SECURITY”
5TH TO 8TH APRIL 2018
MELAKA, MALAYSIA
REGISTRATION DEADLINE: 23RD MARCH 2018
ADMISSION REQUIREMENTS
Willing participants to the Global Food Security Conference“Youth Step Up To Achieve Food Security”must fulfill the following requirements:
Submit filled application forms before Friday, 23rdMarch 2018. The admission of each application will be determined within 3 working days from the submission;
Applicants must be between 18 to 35 years old;
Applicants are requested to submit the following:
  • Passport scan valid for more than 6 months;
  • The latest passport sized picture scan;
  • Filled application form;
  • Applicants must send in written (maximum 700 words) of themselves expressing their understanding of the Conference theme. This should be sent together with the application form. The title of the writing should be “GFSC - [name of applicant]”;
Failure to comply with the above mentioned requirements, the applications will remain pending until all the necessary information are provided to the Organising Committee;
Once the applicant has fulfilled the above mentioned requirements, application(s) must be sent via email to
1. Personal Details
Full Name / Organisation Name
Mailing Address / Position in the organisation
Email (Personal) / Website
Postcode / Phone / Fax
Country / Nationality / ( ) / ( )
Passport Number / Date of Expiry (DD/MM/YYYY) / Date of Birth (DD/MM/YYYY)
2. Travelling Information
2.1 Do you need a Visa to enter Malaysia?
2.2 Arrival Details (Must be on 5th of April 2018)
Flight Number / Date of Arrival (DD/MM/YYYY)
Time of Arrival
AM | PM
2.3 Departure Details (Must be on 8th of April 2018)
Flight Number / Date of Departure (DD/MM/YYYY)
Time of Departure
AM | PM
3. Miscellaneous
Next of Kin / Phone Number / Relation
( )
Please specify if you have any special dietary or medical requirements?

World Assembly of Youth, World Youth Complex, Lebuh Ayer Keroh, Ayer Keroh, 75450 Melaka, Malaysia

Tel: (+606) 2322711 - 2321871 Fax: (+606) 2327271

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