Membership Application Form - ASB

I enclose herewith bank draft / cheque amount S$500 / US$350 payable to DW Associates Pte Ltd being my enrolment administrative investment for Asia Speakers Bureau™.

I agree DW Associates Pte Ltd is entitle to 30% professional service charges from my gross fees, services from assignments, speaking opportunities, consultancies through the Asia Speakers Bureau™.



Sign here………………………NRIC / Passport No: ………………………..……..

Date:

Mail to: DW Associates Pte Ltd, 2 Sin Ming Road, #02-05 Sin Ming Plaza, Tower 1, Singapore 575583

My particulars

Name: …………………………………… Date of birth: ………………………………

Company: ………………………………… Position: .………………………………..

Address: ……………………………….…………………………………………………………..

…………………………………………..…………………………………………………………….

Tel: …………………………………….. Mobile: …………………………………………….

Fax: ……………………………….. Email: …………….……………………………………..

Bank / Cheque No:


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