Registration Form

Registration form

This registration form will be emailed to INSTEP registration focal (Noor Dalilay Lokman at noordalilay.lokman@petronas.com), applicant and sponsor (if any).
For company-sponsored bulk registration (more than 1 participant), pelase refer to Note below.
Kindly contact M Lukman Hakim B Adnan at 09-6686093 or Noor Dalilay at 09-668 6121 for any inquiry on the registration.

Disclaimer: Neither PETRONAS nor INSTEP, has authorised any agency appointment for enrolment of training programme.

Email (default- hidden) *

Instructions:

1. Self-sponsored: Fill up Section B & C

2. Company-sponsored (1 participant): Fill up Section A, B & C

3. Company-sponsored (bulk registration more than 1 participant): Fill up Section A (with attachment Appendix 1 Form) and Section C

4. Section D is mandatory

1. Programme Title *

2. Session Date *

(dd/mm/yy)

3. Venue *

Self-sponsored
Company-sponsored (1 participant)
Company-sponsored (bulk registration more than 1 participant)

A. COMPANY INFORMATION

4. Company Name

5. Company Address for Invoicing Purpose

6. Contacts

Tel. No (O)

Fax No (O)

Person in-charge

(Finance Department)

Attachment:

Click or drag a file to this area to upload.

Upload file field (for company-sponsored for bulk registration only)

B. APPLICANT INFORMATION (Applicable for self-sponsored only)

7. Name

(As per NRIC in capital letters)

8. IC NO. / Passport No.

9. Age

10. Gender

Male
Female

11. Nationality

Malaysian
Others, please specify

Single Line Text

12. Mailing address

City

Postal code

State

13. Contacts

Tel. No (O)

H/Phone

Fax No (O)

C. PAYMENT INFORMATION

14. Course Fee (RM) *

D. PERSONAL DATA PROTECTION ACT (PDPA)

I expressly agree and consent to INSTEP processing my Personal Data (including my Sensitive Personal Data) in accordance with INSTEP Privacy Statement. Click here for details on PDPA Notice or please visit our website at www.instep.my

I expressly agree and consent to INSTEP Terms and Conditions

Note:
1. All information MUST be provided
2. This registration is subject to the Terms and Conditions
3. For company sponsored bulk registration (more than 1 participant), please download and fill up this Appendix 1 Form digitally and do not use pen to avoid any errors. Attach the Appendix 1 Form and click ‘Submit’