NALI2019 Registration

Personal details

First name

Valid first name is required.

Last name

Valid last name is required.

Nric / Passport No.

Your Nric / Passport No. is required.

Username

Your username is required.

Password

Your password is required.

Please enter a valid email address.

Telephone <Country Code><Telephone number>

Please enter a valid telephone number.

Address

Please enter your mailing address.

Address 2 (Optional)

Country

Please select a valid country.

State

Please provide a valid state.

City

Please provide a valid city.

Zip

Zip code required.

Photo/Video Disclaimer

By participating at the NALI2019, you consent to interview(s), photography, audio recordings, video recordings and its/their release, publication, exhibition or reproduction to be used for any purpose by the NALI2019 and Universiti Teknologi Malaysia (UTM) and their affiliates and representatives. You release NALI2019 and UTM, their partners and each and all persons involved from any liability connected with the taking, recording, digitising or publication of video, images, and/or sound recordings. You waive all rights you may have to any claims for payment or royalties in connection with any exhibition or publication. You also waive any right to inspect or approve any photo, video or audio recording taken by NALI2019 or the UTM, or the person or entity designated to do so. If you do not grant your permission to be photographed, filmed or recorded as outlined above, please send a written message to nali@utm.my including a photo of you so that NALI2019 Organisers can take steps to ensure you are not in any photograph or recording.

Zip code required.

NALI2019 Registration Form

Personal details