Concorde Hotel Singapore
ORAL PRESENTATION PARTICIPATION FORM
Please submit this form by 21 July 2017 to Angeline Tan at email: .
Form will only be accepted if all the mandatory fields (*) are filled up.
PERSONAL INFORMATIONSalutation*
Choose an item. / Full Name*
Click or tap here to enter text.
Company / Organisation / Institution*
Click or tap here to enter text. / Department*
Click or tap here to enter text.
Job Title*
Click or tap here to enter text. / Email*
Click or tap here to enter text.
Address*
Click or tap here to enter text. / Postal Code*
Click or tap here to enter text. / Country*
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Office / Home Tel
Click or tap here to enter text. / Mobile Tel*
Click or tap here to enter text.
BRIEF BIOGRAPHY / PROFILE (up to 2000 characters) *
COVER PHOTO*
(You can paste a passport size photo below)
Note:
ç In order to provide attribution for that materials that you are submitting to this conference, information such as Salutation, Full Name, Company / Organisation / Institution, Department, Job Title, Brief Biography / Profile and Cover Photo that are provided above could be used / displayed / published on COMSOL Conference marketing materials (e.g. event website, digital and printed collaterals).
ç Any contact information provided, such as Email, Address, Office Tel, Home Tel, Mobile Tel will be kept strictly confidential and will not be sold, reused, rented, loaned or otherwise disclosed by i-Math Pte Ltd.
IMPORTANT
þ By submitting this form, I hereby confirm my participation in the COMSOL Conference 2017 Singapore and agree to the timeline and terms set by the organizer.
i-Math Pte Ltd
10 Ubi Crescent #06-37 Ubi TechPark Lobby C Singapore 408564 | Website: www.i-math-asia.com | Tel: (65) 6742 1250 | Fax: (65) 6741 1440