|
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 2022 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.
|
|
|
|
|