2012 International Applied Reliability Symposium, Asia Pacific

Industry and government sharing applications, success stories and lessons learned.

October 16 - 18, 2012
Jakarta, Indonesia

ARS, Asia Pacific
Registration Information - One Form Per Attendee
   Advanced Registration (must be received by August 17, 2012 ) 
   Standard Registration 
   Full-Time Student (Student ID Required) 
Please add 7% GST.

SGD 995.00
SGD 1,195.00
SGD 495.00
Submit Registration Via Phone, Fax or Mail:
Phone: +(65) 6272 7422          Fax: +(65) 6272 6687
Mail: ReliaSoft Asia Pte Ltd, No.2 Bukit Merah Central, #14-02 Spring Building, Singapore 159835
Payment Method
 Company Purchase Order (attached)
(Accept Purchase Order from government and industry on NET 30 terms)  

 Check/Money Order (Payable to ReliaSoft Asia Pte Ltd)

 Telegraphic Transfer
Account Name: ReliaSoft Asia Pte Ltd, Bank Number: 7339
Account Number: 534-712997-001, Swift Code: OCBCSGSG
Bank Address: OCBC Bank, 65 Chulia Street, Singapore 049513
All bank charges to be borne by payer. Please ensure ReliaSoft Asia receives full invoice amount.
 Credit Card (Vcode and credit card billing address are required. Please indicate the billing address below or provide it separately.)
Card Type:
  Visa  MasterCard  American Express 

Card Number:
________________________________ Expires: _______ Vcode: ________

Name on Card:

 ______________________________________________________________
Signature: ______________________________________________________________
Attendee Information Billing Information (if other than attendee)
Same as credit card billing address. 
Name: ______________________________
Company: ______________________________
Address: ______________________________
______________________________
______________________________
Phone: ______________________________
Fax: ______________________________
E-mail: ______________________________
Same as credit card billing address. 
Name: ______________________________
Company: ______________________________
Address: ______________________________
______________________________
______________________________
Phone: ______________________________
Fax: ______________________________
E-mail: ______________________________
Additional Information
- Hotel Reservations: You will need to make reservations on your own. Please contact the hotel directly.
- Substitutions: Substitutions are allowed provided that ARS is notified 7 days prior to the Symposium start date.
- Cancellations: Cancellations received up to 15 working days prior to the Symposium start date will be entitled to a full refund of the registration fee minus a SGD 85 administration fee. After this period, all cancellations will be subject to the full fee.
- No Shows: Registrants who do not attend and do not notify ARS of cancellations are subject to the full registration fee.
- ARS reserves the right to cancel/reschedule the Symposium at any time up to 4 weeks prior to its start date. In the event of cancellation, all registration fees will be refunded. ARS is not responsible for any other charges, such as non-refundable airline tickets.
- Registration fee includes attendance to all presentations, copies of the proceedings and any other handouts, daily lunch and refreshments provided during the breaks. A certificate of attendance will be provided. Attendees are eligible for 1 CRP Course Credit.