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31st DISCON Registration
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Email
*
Your email
Applicant Name
*
Your answer
Club Name
*
Choose
RC Muar
RC Singapore
RC Sri Kenyalang
RC Bintulu Central
RC Marina City
RC Kota Melaka
RC Johore Bahru
RC Tanjung Aru
RC Malacca
RC Novena
RC Tanglin
RC Kota Kinabalu Mandarin
RC Kota Tinggi
Rotary Satellite Club Kuching Central City
RC Kuching Central
RC Kinabalu Sutera
RC Miri Oil Town
RC Kota Famosa
RC Kuching Jaya
RC Belait
RC Johor Centennial
RC Singapore Heartlands
RC Kulai
RC Likas Bay
RC Pasir Gudang
RC Tangkak Ledang (Mandarin)
RC Bintulu
RC Pontian
RC Sandakan
RC Penampang
RC Tawau
RC Raffles City
E-Rotaract Club 3310
RC Batu Pahat
RC Kuching South
RC Tebrau
RC Johor Bahru Sentral
RC Bugis Junction
RC Kuching
RC Philanthropic Entrepreneurs Singapore
RC Sibu
RC Shenton
RC Bandar Seri Begawan
RC Tawau Tanjung
RC Johor Straits View
RC Kuching Unity City
Other
RC Kota Kinabalu Pearl
RC Mount Sophia
RC Suntec City
RC Garden City
RC Kota Kinabalu
RC Sentosa
RC Luyang
RC Queenstown
RC Kampong Gelam
RC Yong Peng
RC Changi
RC Singapore West
RC Singapore North
RC Miri
RC Pasir Gudang Mandarin
RC Pandan Valley
RC E-Club of 3310
RC Singapore East
RC Kluang
RC Jurong Town
Rotaract Club of Raffles City
RC Puteri Lagoon (Johor Bahru)
RC Tanjong Pagar
RC Sandakan North
Rotaract Club of UNIMAS
RC Sarikei
RC Kota Kinabalu South
RC Mersing
RC Segamat
RC Bandar Penggaram Mandarin
RC Bukit Timah
Phone number
*
Your answer
Event to be attended
*
Full Event:- Welcome Dinner (27th May) + Conference and Governor's Banquet Dinner (28th May) + Closing Ceremony (29th May) @ RM 462 nett per person
Welcome Dinner only (27th May) @ RM 136 nett per person
Governor's Banquet Dinner (28th May) @ RM 136 nett per person
Welcome Dinner only (27th May) @ RM 136 nett per person + Governor's Banquet Dinner @ RM 136 nett per person. Total = RM 272
Spouse program
*
Yes
No
If yes for spouse program, please fill in your spouse name
Your answer
Holiday Villa Johor Bahru
Bank Detail
Please pay to:
Account Number: 501422101312
Account Name: Rotary Club of Batu Pahat
Bank: Maybank
Please sent the payment receipt to Mr Lau KB at 010-437 1500. And you can contact him for any payment related issue.
A copy of your responses will be emailed to the address you provided.
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