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IEM Penang - Georgetown Heritage Hunt
Team Info
Team(*)
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No. of Team Member(s)(*)
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Participant 1 Info (Leader)
Name(*)
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IC Number(*)
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(without '-')
Gender(*)
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IEM Membership No.
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Contact No.(*)
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Email
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Address(*)
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T-Shirt Size(*)
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Emergency Contact Person(*)
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Emergency Contact No.(*)
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Relationship(*)
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Food Preference(*)
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Participant 2 Info
Name(*)
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IC Number(*)
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(without '-')
Gender(*)
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IEM Membership No.
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Contact No.(*)
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Email(*)
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Address(*)
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T-Shirt Size(*)
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Emergency Contact Person(*)
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Emergency Contact No.(*)
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Relationship(*)
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Food Preference(*)
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Participant 3 Info
Name(*)
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IC Number(*)
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(without '-')
Gender(*)
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IEM Membership No.
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Contact No.(*)
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Email
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Address(*)
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T-Shirt Size(*)
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Emergency Contact Person(*)
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Emergency Contact No.(*)
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Relationship(*)
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Food Preference(*)
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Participant 4 Info
Name(*)
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IC Number(*)
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(without '-')
Gender(*)
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IEM Membership No.
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Contact No.(*)
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Email
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Address(*)
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T-Shirt Size(*)
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Emergency Contact Person(*)
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Emergency Contact No.(*)
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Relationship(*)
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Food Preference(*)
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Participant 5 Info
Name(*)
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IC Number(*)
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(without '-')
Gender(*)
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IEM Membership No.
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Contact No.(*)
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Email
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Address(*)
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T-Shirt Size(*)
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Emergency Contact Person(*)
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Emergency Contact No.(*)
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Relationship(*)
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Food Preference(*)
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Kindly make payment to us as banking details below, and obtain the proof-of-payment before continue to submit this form.

RM 150.00 per Team

Bank name: AMBANK

Bank Address: MENARA LIANG COURT, NO. 37, JALAN SULTAN AHMAD SHAH, 10050 PENANG, PULAU PINANG

Bank Account Number: 002-201-101022-6

Account Name: The Institution of Engineers, Malaysia

Upload Proof of Payment(*)
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You can upload photo (less than 4MB), or Receipt (Scanned, electronic PDF, JPG)
Declaration(*)
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The Institution of Engineers, Malaysia (Penang Branch)
1-4-02, E-Gate, Lebuh Tunku Kudin 2, 11700 Gelugor, Pulau Pinang.
Email : admin(a)iempenang.org / iempenangbranch(a)gmail.com

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