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C LARIDEN Singapore | Sydney | Melbourne | Dubai | Hong Kong | London | New York | San Francisco | Toronto | Auckland HIGHER EDUCATION DEVELOPING SCORECARDS, DASHBOARDS AND KPIS TO SET STRATEGIC PRIORITIES AND DRIVE PERFORMANCE May 29 - 30 SINGAPORE Mandarin Hotel, Singapore 2017 CLARIDEN GLOBAL HIGHER EDUCATION LEADERSHIP INSTITUTE CLARIDEN CREDENTIALS AND ENGAGEMENT Clariden Global is the pre-eminent and influential global business leadership institution. Today, we host more than 200 global executive education and major conference events around the world. We have partnered with professional organizations such as the Association of Chartered Certified Accounts (ACCA) and thought leaders from prestigious universities such as Harvard University John F. Kennedy School of Government, Wharton School of the University of Pennsylvania and Stanford University. Using Balanced Scorecard Method to Drive Greater Efficiency and Productivity

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Page 1: HIGHER EDUCATION DEVELOPING SCORECARDS, DASHBOARDS AND ... · PDF fileHigher Education Developing Scorecards, Dashboards and ... these KPIs can address the unique performance ... Higher

C L A R I D E N Singapore | Sydney | Melbourne | Dubai | Hong Kong |

London | New York | San Francisco | Toronto | Auckland

HIGHER EDUCATION DEVELOPING SCORECARDS, DASHBOARDS AND KPIS TO SET STRATEGIC PRIORITIES AND DRIVE PERFORMANCE

May 29 - 30

SINGAPOREMandarin Hotel, Singapore

2017

CLARIDEN GLOBAL HIGHER EDUCATION LEADERSHIP INSTITUTE

CLARIDEN CREDENTIALS AND ENGAGEMENTClariden Global is the pre-eminent and infl uential global business leadership institution. Today, we host

more than 200 global executive education and major conference events around the world. We have partnered

with professional organizations such as the Association of Chartered Certifi ed Accounts (ACCA) and thought

leaders from prestigious universities such as Harvard University John F. Kennedy School of Government,

Wharton School of the University of Pennsylvania and Stanford University.

Using Balanced Scorecard Method to Drive Greater Effi ciency and Productivity

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The Clariden Experience

Why Clariden Global Executive Education?

Higher Education Developing Scorecards, Dashboards and KPIs

to Set Strategic Priorities and Drive Performance

5 Program Introduction

7 Faculty Director

8 Program Overview

9 Program Outline

Participating Companies

Testimonials

In-house Custom Executive Programs

Contact Us

Registration

3

4

5

11

12

13

14

15

CONTENTS

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To maximize both your enjoyment and professional development, Clariden Global holds its executive

programs at fi ve star hotels, some of which include:

Shangri-La Hotel, SingaporeSingapore

Conrad London St JamesLondon, United Kingdom

InterContinental Melbourne The RialtoMelbourne, Australia

Grand Hyatt: Union Square San Francisco HotelSan Francisco, United States

Amidst lush gardens, this 3-wing luxury hotel is 6

km from the iconic Marina Bay Sands resort and

9 km from Sentosa. 

Across the street from St. James’s Park tube

station, this sophisticated hotel is 10 minutes’

walk from Buckingham Palace and 2 miles from

the Victoria and Albert Museum. 

Set in a grand 1891 building, this upscale chain

hotel is 3 blocks from the Yarra River, and an

8-minute walk from the SEA LIFE Melbourne

Aquarium. 

Less than a block from Union Square, this stylish

high-rise hotel is an 11-minute walk from the

Moscone Center and 1.9 miles from Pier 39.

Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected]

Terms & Conditions: Clariden Global Pte Ltd reserves the right to change the

venue of the program due to reasons beyond their control.

THE CLARIDEN EXPERIENCEENJOY LEARNING WITH THE

FIRST-CLASS, WELL-ROUNDED EXPERIENCE

3

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WHY CLARIDEN GLOBAL EXECUTIVE EDUCATION?

5,000+Companies

15+Countries

10,000+Participants

50+Industries

GLOBAL ENGAGEMENT Clariden Global is the pre-eminent and infl uential global business leadership institution. Today, we host

more than 200 Global Executive Education and major conference events across 15 countries and 17 cities,

including Singapore, London, Hong Kong, Sydney, Melbourne, Perth, New Zealand, San Francisco, Toronto,

Johannesburg, Shanghai, Beijing, Kuala Lumpur, Dubai, Toronto, The Netherlands, New York and Zurich.

INTERNATIONALLY DIVERSE, SENIOR-LEVEL PARTICIPANTSClariden Global Executive Education programs have attracted participants from more than 5,000 global

MNCs, regional corporations, and FORTUNE 500 companies, from more than 40 countries. All applications

are reviewed based on professional achievement and organizational responsibility. Designed for individuals

at all levels, from top executives to emerging leaders, each intensive program is crafted to equip leaders

with essential capabilities to improve corporate performance and position their organizations to thrive.

THOUGHT LEADERSHIPTo provide strategic insights and relevant world-class executive education to global organizations, Clariden

Global engages the best thought leaders and leading authorities from around the world. These include

professors and faculty leaders from Harvard University, Stanford University, University of Pennsylvania

Wharton, London Business School and other premium institutions to deliver transformational knowledge.

Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 4

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Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected]

PROGRAMHIGHER EDUCATION DEVELOPING SCORECARDS,

DASHBOARDS AND KPIS TO SET STRATEGIC

PRIORITIES AND DRIVE PERFORMANCE

5

FACULTY DIRECTOR

PROGRAM ESSENCE

Over 40 years of global expertise in a wide range of strategic performance management disciplines - Balanced Scorecard implementation, policy formulation and practical application roles

• Senior Associate of Balanced Scorecard Institute (BSI)• Recognized by George Washington University for excellent training programs • Led over 300 conferences, seminars and workshops in diverse international locations

Alan FellAlan Fell Consultancy Ltd., UK

Led by Alan Fell, recognized by George Washington University for his excellent training programs, this program will show you how performance systems can be re-designed and embedded to set strategic priorities and drive organisational performance. By linking people, strategy and strategic priorities, you will learn how to put in place a comprehensive performance measurement system that is effectively aligned to your organisation’s strategic priorities and strategy.

With insights from extensive consulting work around the world, Alan will reveal to you principles in creating an institution’s performance measurement drawn from your organisation’s vision. You will discover some of the most important KPIs you need to measure today and how these KPIs can address the unique performance challenges faced by tertiary institutions in Singapore.

DATES29 - 30 May 2017

LOCATIONMandarin Oriental, Singapore

TUITION FEESEarly Bird 1 (Register and pay by 3 April 2017): S$2,595

Early Bird 2 (Register and pay by 1 May 2017): S$2,795

Regular Tuition Fees: S$2,895

Group discount of 10% for 2nd participant from the same organization. For limited time only by 1 May 2017,

register 3 participants and the 4th participant will receive a complimentary seat (One discount scheme

applies).

Note: GST is applicable only to participants from Singapore registered companies. Check your eligibility for

40% Cash Back at IRAS website.

PROGRAM ADVISORZachariah ChanEmail: [email protected]: +65 6899 5030

PROGRAM INFORMATION

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Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 6

1. Understand the unique features and challenges when measuring performance of tertiary education institutions2. Translate strategic vision, mission and objectives into concrete outcomes to build a robust and precise

performance framework to drive both academic and management performance3. Align performance management system to visions and goals to ensure ultimate performance outcomes are met4. Establish strategic priorities and identify important KPIs you need to measure to fulfill the organisation’s

strategic goals5. Develop sustainable budget/financial plans to support performance management system6. Utilize Scorecards, Dashboards, KPIs to successfully implement a performance management system to identify

areas for improvement, deliver performance review, and create a performance culture 7. Develop action plans to improve your institution’s performance management

This executive program is designed for all executives engaged in management, strategy, operations, fi nance

and human resources functions of higher education institutions in Singapore. This would include policy advisor,

President, Chairman, Chancellor, Principal, Provost, Dean, CEO, Managing Director, Board Director, Vice-chancellor,

Deputy Vice-Chancellor, Vice Principal, General Counsel, Head of Department, University Administrators.

KEY BENEFITS

WHO WILL ATTEND THIS PROGRAM

Presenting frameworks, concepts, and tools that examine in depth how world class tertiary education institutions have tackled today’s challenges, you will also learn the steps for successful implementation, as well as planning and managing budgets for performance management system. Last but not least, you will learn to analyse performance data, conduct performance reviews, highlight gaps for improvement and create a performance-driven culture.

At the end of the program, you will walk away with an action plan to improve your organisation’s accountability and performance, and remain competitive in the higher education sector.

PROGRAMHIGHER EDUCATION DEVELOPING SCORECARDS,

DASHBOARDS AND KPIS TO SET STRATEGIC

PRIORITIES AND DRIVE PERFORMANCE

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Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 7

PROGRAMHIGHER EDUCATION DEVELOPING SCORECARDS,

DASHBOARDS AND KPIS TO SET STRATEGIC

PRIORITIES AND DRIVE PERFORMANCE

Alan Fell is a leading, internationally recognized and respected specialist, with over 40 years of financial and business experience in strategic performance management – both in policy formulation and in practical application roles.

Alan was a senior executive with a major UK commercial bank and in his most recent line management role, he was the Head of Planning and Finance for a major division with 3,000 staff. In his Cost Management role, he led a Group-wide cost reduction program, reporting directly to the Group Chief Executive and delivering an 18,000 staff reduction over 3 years, from 108,000 to 90,000 employees.

For the last 18 years, Alan has been operating as an independent management consultant and trainer, covering a wide breadth of closely related topics – from strategic planning and execution through to detailed budgeting and balanced scorecard. He has led more than 300 conferences, public training seminars and customized in-house training in a wide range of international locations, especially in the Middle East/Gulf region, followed by Asia Pacific, South Africa, as well as Europe.

FACULTY DIRECTOR

Alan FellAlan Fell Consultancy Ltd., UK

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Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 8

Increasingly intense competition, as well as constant pressure to match training to industries’ needs are just two among the hosts of challenges which a higher education institution in Singapore faces in its pursuit of organisational excellence and sustainability. These factors make it absolutely essential to strategize, implement, measure and improve not just teaching quality, global reputation but also organisational efficiency. In doing so, institutions will be able to deliver quality education to local and international students and satisfy the diverse groups of stakeholders involved.

Designed for professionals in the higher education sector, this program will arm you with strategic planning and performance measurement tools that will enhance your institutions’ performance and competitiveness for long-term sustainability in the global higher education market. Led by Alan Fell, a leading expert in balanced scorecard development, management and implementation, you will learn how to carry out strategic planning and identify key performance indicators from your organisation’s vision and mission to help align performance measures with long-term strategic plans. You will develop a robust and precise performance measurement system through the use of Scorecards, Dashboards, and KPIs to drive and improve both academic and management performance in your institution.

Through case studies and hands-on exercises, learn strategies and steps to implement a performance measurement system that effectively monitors organisational efforts, from which you can identify gaps for improvement and create a performance-driven culture. Last but not least, you will learn to build and manage budget for performance management system to ensure ultimate and long-term system outcome.

At the end of the program, you will walk away with an action plan to improve your organisation’s accountability and performance, and remain competitive in the higher education sector.

OVERVIEW

PROGRAM OVERVIEWHIGHER EDUCATION DEVELOPING SCORECARDS,

DASHBOARDS AND KPIS TO SET STRATEGIC

PRIORITIES AND DRIVE PERFORMANCE

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Course introduction – and overview of Performance Management within higher education institutions• Delegate introductions• Overview of strategic management – planning and execution• The scope of performance measurement and management and the importance of employing relevant KPIs• The concept of the (Balanced) Scorecard and dashboards • Special features / examples of driving performance results in higher education institutions

Driving results in higher education institutions• Unique features / challenges of this industry sector• Examples of applying the Balanced Scorecard (“BSC”) within higher education institutions• Integrating Scorecards / Dashboards within this industry: combining a strategic and operational perspectivesDelegates to present on their specific issues / challenges

Establishing a clear and coherent Vision and Goal(s) • Understanding why these core management issue are so often a “weak link” in the whole management process

– and what is good practice to avoid these problems• The 3 components of an effective Vision• Good and “not so good” examples from within the industry• Aligning and validating the overall Goals of the institution

Clarifying strategic priorities – and the related KPIs• Choosing the route to achieve the overall goals• The customer value proposition and the strategy canvas• Summarising the strategy as a cause-and-effect Strategy Map• Translating strategy into a carefully selected set of KPIs• Targeting and re-forecasting / rolling forecasting

DAY 1

Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 9

08:30 - 18:00 / 29 May 2017

PROGRAM OUTLINEHIGHER EDUCATION DEVELOPING SCORECARDS,

DASHBOARDS AND KPIS TO SET STRATEGIC

PRIORITIES AND DRIVE PERFORMANCE

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Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 10

PROGRAM OUTLINEHIGHER EDUCATION DEVELOPING SCORECARDS,

DASHBOARDS AND KPIS TO SET STRATEGIC

PRIORITIES AND DRIVE PERFORMANCE

KPIs relevant to higher education institutions• A review of commonly employed KPIs for the industry – and why, strategically, they are important• An open session on “how can we measure XXXX” ?Delegates are encouraged to consider the KPI challenges that they face and bring these to this session for discussion

Aligning the strategic priorities to operations and finance / budget• Getting the balance right at management level between strategy and operations (most managers struggle with

the correct balance: how can this be achieved?)• Strategy does not work unless it is funded: ensuring the alignment of strategy to budget

Note: survey tells us 60% of organisations fail in this alignment – creating one of the most common factors for failure of strategy execution

• The concept of “stratex” and the analysis between business as usual and the investment in strategic change

Using Scorecards / Dashboards / KPIs properly to drive performance value• Simply having KPI data does not, in itself, create value. Management need to make good use of this information

to help deliver the strategic priorities and improve performance results.• Creating and sustaining the right performance culture• The dynamics of the management review process• Establishing and enforcing the “rules of engagement” to ensure an successful regular management process

Concluding session / action steps• Each delegate to prepare a personal action plan with relevant improvements to the performance management

of their Higher Education institution• Delegates will have the option of briefly presenting their conclusions to the course group as a whole

DAY 2

08:30 - 18:00 / 30 May 2017

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PARTICIPATING COMPANIESMore than 5,000 companies have participated in our programs

ADVERTISING, INTERNET, MEDIA,PUBLISHINGBBC Worldwide

CNN

eBay

LinkedIn

MediaCorp

Saatchi & Saatchi

Singapore Press Holdings

The Financial Times

The Hoffman Agency

The Walt Disney Company

Thomson Reuters

CONGLOMERATEFraser & Neave

General Electric

General Motors

Mitsubishi

Monsanto

Siemens AG

Sodexo

FINANCIAL SERVICES, INSURANCEBank of America Merrill Lynch

AIA

Allianz Global Investors

American Express

Aviva

AXA

Barclays Bank

Citibank

DBS Bank

Deutsche Bank

HSBC

JP Morgan Chase Bank

Manulife

MasterCard

Maybank

Mizuho Bank

OCBC Bank

PayPal

Prudential

Rabobank

Standard Chartered Bank

Suncorp

Swiss Reinsurance

TD Securities

Visa

Westpac

Zurich Insurance

FOOD, BEVERAGECoca-Cola Beverages

Danone

Ferrero

Heineken

McDonald

PepsiCo

Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 11

GOVERNMENT, NONPROFITAustralian Securities and Investments

Commission

Central Provident Fund Board

Changi Airport Group

Economic Development Board

GIC

NSW Treasury

Serco

Temasek Group

HEALTHCARE, PHARMACEUTICALSAbbott Laboratories

Eu Yan Sang

Glaxosmithkline

Hoffmann-La Roche

Johnson & Johnson

Merck

Pfi zer

Sanofi

HOSPITALITYCapitaLand

Far East Organization

Frasers Hospitality

Hilton Worldwide

Marriott Hotels

Pan Pacifi c Hotels Group

Shangri-La Hotels & Resorts

MANUFACTURING (CONSUMER)British American Tobacco

Estee Lauder

Fonterra Brands

Heineken

Kimberly-Clark

Kraft Foods

Lego

Mars Foods

Nestlé

Procter & Gamble

Unilever

MANUFACTURING (INDUSTRIAL)Airbus

Corning Optical Communications

Daimler

Harley Davidson

Intel Semiconductor

Rolls-Royce

Volvo Group

Wearnes Automotive

OIL & GAS, NATURAL RESOURCESCaltex

Chevron

ConocoPhillips

ExxonMobil

Maersk

Petronas

Santos

Saudi Arabian Oil

Schlumberger

Shell

PROFESSIONAL SERVICESAECOM

Aon Hewitt

Ernst & Young

PricewaterhouseCoopers

RETAIL, TRADEAdidas

Cargill

DFS

Harvey Norman

Hennes & Mauritz

IKEA

L’Oreal

Marks and Spencer

NTUC Fairprice

Tesco

TECHNOLOGY, ELECTRONICS3M

Apple

Canon

Dell

Hewlett Packard

Intel Technology

Lenovo

Micron Technology

Microsoft

Oracle

SAP

Sony Electronics

TE Connectivity

TELECOMMUNICATIONSEricsson

Nokia

Olive Communications

Singtel

Starhub

Tata Communications

Telstra

Verizon

Vodafone

TRANSPORTATIONAuckland Transport

Cathay Pacifi c Airways

Dubai Air Navigation Services

New Zealand Transport Agency

Fiji Airways

Metro Trains Melbourne

NSW Trains

SBS Transit

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FACULTY DIRECTOR

ALAN FELL’S TESTIMONIALS

questions were specifi c,

relevant and practical. The

content on this course was

detailed and well-explained

with relevant scenarios and

real-life experiences. The

work-plans shared during

the training were very

helpful to ensure actionable

implementation.

Alan has in-depth knowledge on

strategy execution along with a

valuable consulting experience.

I found this course very well-

structured with the right mix of

all pedagogy techniques to tell

you how to engage everyone in an

organisation to execute strategy.

Raju Prasad, QA Manager, Abunayyan Holding, KSA

Adon Quin, Director of Operations, Majed Al Futtaim Group, UAE

““ ““

Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 12

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PROGRAM ADVISORZachariah ChanEmail: [email protected]: +65 6899 5030

Alan Fell is a leading, internationally recognized and respected specialist, with over 40 yearsof financial and business experience in strategic performance management – both in policy formulation and in practical application roles. For the last 18 years, Alan has been operating as an independent management consultant and trainer, covering a wide breadth of closely related topics– from strategic planning and execution through to detailed budgeting and balanced scorecard. He has led more than 300 conferences, public training seminars and customized in-house training in a wide range of international locations, especially in the Middle East/Gulf region, followed by Asia Pacific, South Africa, as well as Europe.

CONTACT US

Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 13

IN-HOUSE

CUSTOM

EXECUTIVE

PROGRAMS

Clariden Global delivers custom learning programs for organizations all around the world. Whatever your business

challenges are, we create focused learning experience that enables your organization to achieve success. Through

partnerships with the most renowned thought leaders, industry experts and professors from around the world,

these in-house custom executive programs will equip you with essential skills and capabilities to develop and

implement strategies more effectively at your organization.

Engage with our thought leader today:

Alan FellAlan Fell Consultancy Ltd., UK

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CONTACT US

Contact Zachariah Chan, Program Director at +65 6899 5030 l [email protected] 14

We encourage you to learn more about Clariden Global Executive Education custom and open-enrollment programs.

Our staff will be happy to answer your questions and help you determine the programs work best for you and your

organization.

ENQUIRY FOR THIS PROGRAMZachariah ChanEmail: [email protected]: +65 6899 5030

SINGAPOREEmail: [email protected]

Phone: +65 6899 5030

Fax: +65 6567 4328

Address: Clariden Global Pte Ltd 3 International

Business Park #04-29, Nordic European

Centre Singapore 609927

LONDONEmail: [email protected]

Phone: +44 (0) 20 7129 1222

Fax: +44 (0) 84 3218 0413

Address: 1 King Street London,

EC2V 8AU United Kingdom

AUSTRALIAEmail: [email protected]

Phone: +61 3 9909 7310

Fax: +61 3 9909 7788

Address: Clariden Global Pty Ltd

530 Little Collins Street, Level 1

Melbourne VIC 3000, Australia

CUSTOMIZED PROGRAMSZachariah ChanEmail: [email protected]: +65 6899 5030

REGISTRATION & PAYMENT MATTERSEmail: [email protected]

Phone: +65 6899 5030

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REGISTRATION

C L A R I D E N

Program (29 - 30 May)Higher Education Developing Scorecards, Dashboards

and KPIs to Set Strategic Priorities and Drive

Performance

S$2,595 S$2,795 S$2,895

PROGRAM FEES

Program1st Early Bird Fee

(If payment & registrations are received

by 3 Apr 2017)

2nd Early Bird Fee(If payment &

registrations are received by 1 May 2017)

Regular Fee Per Participant

Mandarin Oriental, Singapore

29 - 30 May 2017

5 Raffl es Avenue,

Marina Square, Singapore 039797

(65) 6338 0066

Website: http://www.mandarinoriental.com/singapore/

Email: [email protected]

Fax: +65 6567 4328

Call: +65 6899 5030

Website: www.claridenglobal.com

By Cheque/ Bank Draft

By Telegraphic Transfer

By Credit Card

Group discount of 10% for the 2nd participant from the same organization.

For limited time only by 1 May 2017 register 3 participants and the 4th

participant will receive a complimentary seat.

*One discount scheme applies.

An invoice and registration confi rmation will be sent within 7 days, please

contact us if you have not heard from us within 7 days. Payment details will

be sent together with the invoice based on your preferred payment method.

ALL PAYMENTS MUST BE RECEIVED IN ADVANCE OF THE EVENT.

Accommodation is not included in the program fee but you will be entitled

to use our corporate rate for your accommodation. Information will be sent

along with your registration confi rmation.

Once we have received your booking, the place(s) are confi rmed. No refunds

will be made for any cancellations, however, program credits of equivalent

value only applicable for Clariden Global events will be provided. Credits

can only be redeemed for 1 program and is valid for only one (1) year from

date of issue.

Substitution with a qualifi ed candidate is allowed by providing at least 5

working days of advance notice to Clariden Global. One time substitution

is allowed with no charges. Subsequent substitutions will be charged 10%

admin fee.

PLEASE NOTE: Clariden Global Pte Ltd reserves the right to change the

content and timing of the programme, the speakers and the date and venue

due to reasons beyond their control. If in the unlikely event that the course is

cancelled, Clariden Global Pte Ltd will refund the full amount and disclaim

any further liability.

PRIVATE DISCLOSURE STATEMENT: Any information provided by you in

relation to this event is being collected by Clariden Global Pte Ltd and will

be held in the strictest confi dence. It will be added to our database for the

primary purpose of providing you with information about future events and

services.

4 WAYS TO REGISTER 3 PAYMENT METHODS

VENUE AND ACCOMMODATION INFORMATION

CANCELLATIONS AND SUBSTITUTIONS*All cancellations must be received in written form.

GROUP DISCOUNTS

FEE RECEIVED REFERENCE L7148/VL/ZC

FOR OFFICIAL USE

Booking Contact (Approving Manager) Mr/Mrs/Ms:___________________

Job Title:____________________ Department:____________________

Telephone:_______________________ Fax:_______________________

Email:______________________________________________________

Organization:_______________________________________________

Address:____________________________________________________

____________________________________Postal Code:____________

I would like to receive more information on hotel accommodation

using Clariden Global coporate rate.

Please register the following participant for this seminar.

(Please tick to select your seminar(s). You may tick more than one.)

1st Participant Name (Mr/Mrs/Ms):_________________________________

Job Title:___________________ Department:__________________________

Telephone:_________________________ Fax:_________________________

Email:_________________________________ Date of Birth:_____________

2nd Participant Name (Mr/Mrs/Ms):_________________________________

Job Title:___________________ Department:__________________________

Telephone:_________________________ Fax:_________________________

Email:_________________________________ Date of Birth:_____________

3rd Participant Name (Mr/Mrs/Ms):_________________________________

Job Title:___________________ Department:__________________________

Telephone:_________________________ Fax:_________________________

Email:_________________________________ Date of Birth:_____________

4th Participant Name (Mr/Mrs/Ms):_________________________________

Job Title:___________________ Department:__________________________

Telephone:_________________________ Fax:_________________________

Email:_________________________________ Date of Birth:_____________