Hong Kong Case Workshop Registration Form

Ivey Case Teaching and Writing Workshop Registration Form

Module Selection

Please select the module below to which you would like to apply:

Full Case Workshop (Teaching & Writing); Date: April 15-18, 2019; Fee: USD3,000Case Teaching Only; Date: April 15-16, 2019; Fee: USD1,500Case Writing Only; Date: April 17-18, 2019; Fee: USD1,500

*The fee listed above covers all workshop materials, administrative and reproduction services, coffee breaks and luncheons. Participants are expected to cover their own transportation and other living costs.

Discounts:

Discount for 3 or more registrations from the same organization

Participant Information

All information collected will be kept confidential.

Salutation:

Mr.Mrs.Ms.Dr.Prof.

First Name:

Last/Family Name:

Preferred Name:

Email Address:

Contact Number:

Job Title:

Organization:

Special Dietary Requirement:

Do you require an invitation letter?

YesNo

Mailing Address

Address	City
Province / State	Postal Code / Zip Code
Country

Payment Information

Participant fees must be submitted prior to commencement. Payment shall be made in US dollars or Hong Kong dollars (US $1 = HK $7.8).

Payment Type

By ChequeBy Bank Transfer (Local or Overseas)

Yes, an invoice is required.

Invoice Information

1. Invoicee Name:

2. Invoicee Title:

3. Invoicee Company Name (if any):

4. Invoicee Address:

5. Invoicee / Account Department Contact Number:

Terms of Enrolment

Cancellation and administration fees apply to program withdrawal and rescheduling. Please contact Ivey at cases@ivey.com.hk for details.

Applicant Declaration

I hereby certify that the above information is a true record of my personal information, and that I have provided all the required information. My signature on this application represents my agreement to enroll in the indicated program and other terms above.

Applicant Signature (type your name):

Date:

Please contact us at +852-2135-2222 or cases@ivey.com.hk if you need any assistance.

Contact Information