Register Now - Amalgam Leadership

PERSONAL INFORMATION

Last Name *

First Name *

Middle Name *

Prefix (Mr. Ms.) *

Nickname/Familiar name for name badge

Gender

Male Female

Mobile Phone No. *

Personal Email Address. *

Work Email Address. *

Country of Citizenship *

Date of Birth *

Title or Position *

Division (if applicable)

City

ORGANISATION INFORMATION

BILLING INFORMATION

An invoice will be emailed to the individual indicated below

Last Name *

First Name *

Middle Name *

Prefix (Mr. Ms.) *

Title or Position *

Company/Organisation Name *

Street *

City *

Building *

Postal Address *

Postal Code *

Telephone. *

Email *

TERMS OF PAYMENT

Terms of Payment and Cancellation Policy

Terms of payment: To confirm your booking payment must be received within 30 days from date of invoice. In cases where acceptance into the Programme happens within 29 days to the Programme start date, payment is required prior to the Programme start date.

Cancellation policy: Cancellations must be submitted in writing more than 45 days before the Programme start date to receive a full refund. Cancellations received 30 to 45 days before the Programme start date are subject to a fee of one-half of the Programme fee. Requests received within 30 days of the Programme start date are subject to full payment of the Programme fee.

Refunds are exclusive of VAT

I have read and understood the terms of payment and cancellation policy and hereby confirm my agreement. *

Confirm

Please fill the form below and submit to register for the Amalgam Leadership Programme

PERSONAL INFORMATION

ORGANISATION INFORMATION

Please indicate the amount of prior experience and familiarity you have with each of the following areas or activities.

Leadership *

Finance *

Marketing *

Technology *

BILLING INFORMATION

TERMS OF PAYMENT

Terms of Payment and Cancellation Policy

Register for the Programme