MNS Hornbill Conservation Volunteer Programme 2010

JKR 641, Jalan Kelantan, Bukit Persekutuan, 50480 Kuala Lumpur

Tel : 03-2287 9422 Fax : 03-2287 8773 E-mail : community@mns.org.my

Attn: Ms. Jessie Ong

YES, I would like to enroll in your MNS Hornbill Conservation Volunteer Programme.

APPLICANT’S INFORMATION
Name: Dr / Mr / Mrs / Ms* :
I.C. / Passport No:
Nationality:
Postal Address:

Telephone: Fax: H/P:

E-mail:
Trip date: T-shirt size* : S / M / L / XL / XXL

Rates: 4D 3N package:
[ ] RM230, MNS member (Membership no: _____________________)
[ ] RM300, Malaysian resident (non-MNS member)
[ ] USD150, International participant
[ ] RM170, Student

5D 4N package:
[ ] RM280, MNS member (Membership no: _____________________)
[ ] RM350, Malaysian resident (non-MNS member)
[ ] USD180, International participant
[ ] RM220, Student

PAYMENT INFORMATION
I enclose RM/USD*________ (Cash / Chq / Bank Draft / MO / PO* no: _________________)
OR
Debit my VISA / MASTERCARD* no: ________-________-________-_________
Name on card: ___________________________________________________
Amount: RM__________ Expiry Date (mm-yy): ______________
Signature: ________________________ Date (dd-mm-yy): _________________
OR
Bank-in to : Maybank 012 138 304 679 / HSBC 305 194 920 108 *
Bank-in Date (dd-mm-yy): _________________
Note: Kindly send us the bank-in slip by e-mail or fax to 03-2287 8773.
* Please circle the appropriate.
For Office Use Receipt no.:
IMPORTANT
1. Confirmation and full payment must be made two (2) weeks upon submission of form to MNS.
2. Paid booking is confirmed booking.

Note: All proceeds will be channeled into the MNS Hornbill Conservation Project.

Agreement
1. I hereby agree to fully indemnify and absolve the organizers of the MNS Hornbill Conservation
Volunteer Programme and MNS, their employees and/or agent from any claim and/or liability
that may arise out of any damages, injury, death or loss of property howsoever arising from my
participation in the Hornbill Conservation Volunteer Programme.

2. I subscribe to the guidelines mentioned below:

Do’s and Don’ts

i. Volunteers are advised against swimming in the lake for the own safety. Please ensure a
guide is present if volunteers insist on swimming.
ii. No jungle trekking unaccompanied by a guide is permitted.
iii. No collection of plants, seeds, insects and animals are permitted.
iv. Please ensure you use a cap and have sun block at all times for protection.
v. Alcohol and non-halal food are not allowed at the field accommodations.
vi. No photography allowed during the Plain-pouched Hornbill counts, as we need the
volunteers’ full concentration on the counts.
vii. No loud music and campfires allowed. This is a village area and we must respect the
community that lives there.
viii. Please feel free to contribute photographs of the survey to MNS and our magazine,
Malaysian Naturalist and upcoming website: www.hornbills.org

Do you have special dietary requirements? If yes, please state……………………………………………………

In case of emergency, please provide 2 possible contacts for MNS to get in touch:
Name Home Tel / Mobile Number

1.

2.

_____________________
Signature

Date: