MC_RS 001/2017-2018
MC Reading Seminars 2017 Course Registration Form
Please fill the form and return it to the Reception @ Martin Chautari by 28 February 2017.
Name ______________________________________________ Contact Address _____________________________________ Email ______________________________________________
Please affix your photo here
Education (mention only the last formal degrees) Degree
Institution
Year
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Work (mention only the current if applicable) Where
Position
Year
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Course Title _______________________________________________________ Course Dates ______________________________ (Mondays and Thursdays) Preferred Times (please rank them according to your preference) Rank
Times
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6:30 – 9:00 hrs
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14:30 – 17:00 hrs
Course Fees _______________ Please let us know, briefly, why you want to take this course and what do you expect to gain by this course: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Please also let us know how you came to know about this course (please tick one): (a) MC website (b) a colleague (c) social media (d) others (please specify) ______________
