PLEASE REGISTER ONLY ONCE, REPEAT REGISTRATION WILL BE IGNORED.

PLEASE PROVIDE VALID EMAIL ADDRESSES, WE WILL NOT BE LIABLE FOR INVALID EMAIL(S) PROVIDED BY REGISTRANTS.

Fields marked * are mandatory


PARTICIPANT’S INFORMATION (please complete the details)
 
Title : Mr Mrs Ms Miss Others:  (eg: Type Tan Sri, Dato Sri, Dato etc.)
First Name :
Surname :
Company :
Job Title :
Correspondence Address :
District/City :
State :
PostCode :
Country :
Mobile Phone : (e.g. 60123456789)
Country Code       Area Code    Number
Telephone : - - (country code-area code-number - e.g. 60-3-12345678)
Facsimile : - - (country code-area code-number - e.g. 60-3-12345678)
Email Address :
 

SURVEY (please complete all the questions)

A. NATURE OF BUSINESS (Please tick all that apply)
01. Manufacturer
02. Wholesale
03. Retail
04. Hospital
05. Government
06. Student
07. Others (Please specify)

B. YOUR PROFESSION IS (Please tick all that apply)
01. Optometrist
02. Optician
03. Optometry student
04. Others (Please specify)

C. ARE YOU BUSINESS OWNER? (tick one box only)
01. Yes
02. No

D. YOU ARE A MEMBER OF (Please tick all that apply)
01. AMO – Association of Malaysian Optometrist
02. MAPO – Malaysian Association of Practising Opticians
03. MOA – Malaysia Optometry Association
04. MOWA – Malaysian Optical Wholesalers Association
05. Others (Please specify)

E. REASON FOR VISIT (Please tick all that apply)
01. Attending Fair Events (eg. Seminar, meetings, Gala Dinner etc.)
02. Shopping for good products bargain (eg. Products promotion.)
03. Attracted to freebies, lucky draw prizes, contest etc.
04. Update knowledge on latest products, technology and trend.
05. Others (Please specify)

Personal Data supplied is held subject to the Data Protection Act 2010. Information provided by you will be used for administration and marketing purposes regarding products relevant to you.

Optical Fair 2020 is a trade event. No admittance to anyone under the age of 12, Parents will take full responsibility on the safety of their children and Organizer will not be liable if any accident occur.