團隊負責人填寫

For Team Leader Use 

2007 國際口琴演奏嘉年華 (馬來西亞) 
International Harmonica Carnival 2007 

付款表格 Payment Detail 


團體名稱

Organization 
代表/負責人
Team Leader 

※國際演奏嘉年華通行證包括報名費、歡迎晚宴、閉幕典禮晚宴以及嘉年華優惠券
Carnival Pass includes Registration fees, both Welcome and Closing Ceremony Dinner and Vouchers 

※所有出席國際嘉年華的人士必須持有通行證
  All participant MUST possess the Carnival Pass 

※凡是有參加邀請賽的人士，必須繳付參賽報名費
  A registration fee is required for all competitors. 

※邀請賽的報名費，則是每首參賽樂曲的表演人數乘以美金USD12( 或馬幣RM 40) 的總數
  Registration fees for each piece of music registered for entry is USD12 (or RM40) per pax. 
通行證
Carnival Pass 
數量Qty 
A X 美金USD 
X 馬幣RM 
48 
160 
= 
= 
總額 Cost 
C1 
C2 
參賽報名費
Competition Reg.Fees 
B X 美金USD 
X 馬幣RM 
12 
40 
= 
= 
D1 
D2 
TOTAL 總數美金USD 
馬幣RM 
(C1+D1) 
(C2+D2) 

匯款方式支票 Cheque ( 馬來西亞 Local) 
Mode of Payment 銀行匯票 Bank Draft ( 海外 Oversea) 
電匯 Telegraphic Transfer [TT] ( 海外 Oversea) 
請匯至 Payable to: M HARMONY 

銀行帳號 Account No.: 314 097 6812 
銀行 Banker: Public Bank Berhad 

Internal Use Only 行政用途

Form received by : _____________________________________ date: _______________________ 
Fees received by : ______________________________________ date: _______________________ 
Demo received by: Qty:_______ Condition: _____________________________________________ 
Registration Status: ______________________________________ by: _______________________ 
Follow up status:


 Acknowledgement Letter ___________________________________________ 
 Receipt issue: ____________________________________________________