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Title

First Name

Last Name

Date of Birth (DD/MM/YYYY)

Gender

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Job Sector

Job Position

Department

Organisation/ Company / Institution

Primary Email Address

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Additional Emails

Office Tel No

Mobile Phone No

LinkedIn URL

Dietary Requirements

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Billing First Name

Billing Last Name

Billing Address Email

Billing Organisation

Billing Address Line 1

Billing Address City

Billing Address State

Billing Address Postcode

Billing Address Country

By submitting this form, I am deemed to have fully read and understood the Privacy Notice for Event which can be viewed at https://www.utp.edu.my/sites/Publishing/PublishingContent/privacy-notice-general.pdf and I hereby acknowledge receipt and agree to the contents of the same. I confirm that I consent and agree to the collection, processing, use, disclosure, retention and transfer by the Universiti Teknologi PETRONAS of my personal data (including sensitive personal data) for the purpose of this form and in the manner as set out in the Privacy Notice and applicable laws.*

YES

I consent to UTP processing my Personal Data for direct marketing purposes, and to receive marketing, advertising and promotional information, materials and/or documents about UTP’s products and/or services, or such products and/or services by UTP’s business or strategic partners, and any related promotions, programmes, events, or contests organized by UTP.

YES

UTP is participating in the rating and ranking of higher educational institutions including but not limited to Quacquarelli Symonds (QS) and Times Higher Education (THE). For this purpose, UTP is required to disclose your contact details to the rating and ranking agencies in order for them to contact you to participate in the exercise.

YES

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1 NPD Registration Form

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