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| Note : |
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Please complete all required fields ( * ) before submitting. Incomplete submissions will be rejected.
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| ( 2 ) |
The Organiser reserves the right of refusal if the registrant is not a valid trade visitor.
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| ( 3 ) |
Please fill in the form with all capital letter. |
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PARTICIPANT’S INFORMATION
(please complete the details)
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| * Name : |
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| * Job title : |
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| * Company : |
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| * Mailing address : Address 1 : |
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Address 2 : |
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Address 3 : |
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District / City : |
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State : |
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Postal Code : |
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* Country : |
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| * Email Address : |
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| * Alternative Email Address : |
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Country Code Area Code Number |
| * Telephone : |
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- (country code-area code-number - e.g.
60-3-12345678) |
| Facsimile : |
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- (country code-area code-number - e.g.
60-3-12345678) |
| Mobile Phone : |
(e.g.
60123456789) |
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SURVEY
(please complete all the questions)
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1. The classification which best describes your organization is ? (Please tick) |
 01. Ministry / Government
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02. Environment / Civil Engineering Consultants
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03. Food / Drinks / Beverages / Distillery / Brewery
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04. Palm Oil / Sugar Refining
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05. Petrochemical / Chemical / Oil and Gas
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06. Steel
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07. Pulp and Paper
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08. Sewerage Companies / Operators
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09. Town / City Councils
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10. Water Companies / Operators
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11. Hospital / Hotels / Clubs
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12. Research Institutes / Education
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13. Architects
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14. Real Estate Developers
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15. Building Contractors
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16. Auto Parts / Automotive
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17. Agriculture / Palm Oil
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18. Electronics / Semiconductor / Electrical Industry
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19. Pharmaceutical / Cosmetic / Medical
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20. Agents / Distributors
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21. Others (Please specify) :
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2. Which best describes your job title? (Please tick) |
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01. Owner / Chairman / Managing Director
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02. Department Head
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03. Project Engineering
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04. Contractor
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05. Plant Management
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06. Purchasing
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07. Design / Development
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08. Consultant
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09. Sales / Marketing
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10. Others (Please specify) :
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3. Do your specify, approve, purchase or influence the purchaser of products and services in your organisations? (Please tick) |
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01. Yes
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02. No
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4. How many employees are there in your company / department (all locations)? (Please tick) |
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01. 1 - 20
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02. 21 - 100
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03. Over 100
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5. How did you come to know of ASIA WATER 2012? (Please tick) |
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01. Newspaper
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02. Magazine
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03. Invitation
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04. Radio
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05. Others (Please specify) :
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