International American University: Graduation Ceremony 2010 Registration Form

7th December 2010, Palace of the Golden Horses at Mines Resort City, Kuala Lumpur, Malaysia.

Personal Details:
Full Name:       Student ID No.:      
(name to appear <capital
letters> on certificate and
transcript)
Correspondence Address:      
City, State/Province:      
Country Postal Code:      
Tel No.:       H/p:       Email:      
Academic Details
Program: (please tick) PhD DBA Master Bachelor Associates
Major: (if any)      

Graduates: USD $400 per pax inclusive of the following:

• Gown, mortar board & hood rental.
• 3 Photos with cover: (1) receiving scroll (2) group photo (3) personal photo.
• DVDs
• Dinner: 8 courses menu

Guests: USD $60 per pax (inclusive of entrance into the graduation hall AND Invitation for dinner).
Adults and children will have to pay the same price.

All graduates and guests are to bring along and present their invitation cards. Graduates or guests without
invitation cards will not be able to enter the graduation hall or dinning hall.

Please state the number of guest tickets required:     .

Kindly fill and return this form with full payment to Net Academy Office the latest by 30th August 2010. Late Entries will not be
entertained. No cancellation is allowed once this form has been received by Net Academy.

Net Academy address and Contact Payment details:

No. 1A, Jalan Anggerik Tel: 603-5122 7058 / 9058 Payable to: Net Academy Sdn. Bhd.
Vanilla N31/N, Fax: 603-5122 9496 A/C No.: 7127 8100 0026
Kota Kemuning, Email venus@netacademy.com.my Bank: Maybank Berhad
40460 Shah Alam, Selangor Swift Code: MBBEMYKL
Malaysia. Bank Add: 9&11 Jln Anggerik Vanilla N31/N,
Kota Kemuning, 40460 Shah Alam,
Selangor, Malaysia.

Accommodation Information for Outstation / Overseas Students and Guests

For your convenience, please be informed that if you or your guest(s) require accommodation at the Palace of the Golden
Horses, you will be able to obtain a discounted rate if you book and pay through NetAcademy. Please book ASAP as only
limited rooms available. Details are:

• Deluxe room at USD 100 nett (normal price: USD 200++ and above) with 2 breakfast.
++ 5% government tax and 10% service charge.

If you require this service, please fill in the following information:

Guest Name:       (Booking purpose only)
Number of rooms needed:       Double bed King size bed
Check in date:       Check out date: