workshop application form
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BORANG PENDAFTARAN / REGISTRATION FORM
PROFESSIONAL & PERSONAL DEVELOPMENT WORKSHOPSINSTITUTE OF POSTGRADUATE STUDIES
1. Nama (Name) : ____________________________________________________
2. No. Matrik (Matric No.) : ____________________________________________________
3. Pusat Pengajian (School) : ____________________________________________________
4. Warganegara : ____________________________________________________ (Nationality)
5. No. K/P /No. Pasport : ____________________________________________________ (IC No. /Passport Number)
6. Tel. bimbit : ____________________________________________________ (Handphone No.)
7. E-mel (E-mail) : ____________________________________________________
8. Program (Programme) : ____________________________________________________
Saya ingin mengikuti latihan berikut:(I wish to attend the following course):
Title/Tajuk Date/Tarikh
(i)
(ii)
(iii)
(iv)
(v)
________________________________ _________________________
Tandatangan Tarikh (Signature) (Date)
SEKRETERIAT BENGKELU.P.: Puan Intan BaizuraE-mel: [email protected] Tel. : 04-6532359
WORKSHOP SECRETARIATATTENTION: Puan Intan BaizuraE-mail: [email protected] Tel. : 04-6532359