* Participant's name:

* Job title:

* Mobile No :

* E-mail :

Company Profile

* Company's name:

Address:

* Tel:

Fax:

E-mail :

Web:

Remarks:

* Seminar: (Please tick mark the following options to attend the session)

I^st Sesssion: 11:00 a.m - 12:30 p.m
2^nd Sesssion: 03:00 p.m - 04:30 p.m

* Its request for participation and never means that your seat has been reserved. After viewing your detailed company information VIVA Telecom will confirm you.

* Must be filled