BORANG PENDAFTARAN PESERTA RANCANGAN ANDA ADA 60 SAAT
REGISTRATION FORM FOR THE PROGRAMME ANDA ADA 60 SAAT
Sila lampirkan bersama salinan Kad Pengenalan dan sekeping gambar berukuran 4R (Gambar profil kepala hingga
paras pinggang) please enclosed together a copy of NRIC and one 4R photograph (profile picture from waist up)
NAMA
PENUH:..............................................................................................
full name:
NAMA PANGGILAN/TIMANGAN :...........................................................
nick name:
WARGANEGARA:.............................
nationality
BANGSA :........................................
race
AGAMA:..........................................
religion
NO K/P:........................................ UMUR:................. TARIKH LAHIR:........................... JANTINA (P/L):..........
New NRIC age date of birth sex (f/m)
TINGGI:.......... BERAT:......... SAIZ KASUT:....... SAIZ PAKAIAN: BAJU T:.......... KEMEJA:......... PINGGANG:.......
height weight shoe size wardrobe size t-shirt shirt waist
TEL
RUMAH:...........................................................
residential tel no
TEL BIMBIT 1:.................................................
mobile tel no 1
TEL BIMBIT 2:............................... .................
mobile tel no 2
E-MAIL:......................................... .................
e-mail
LAMAN SOSIAL (FB, MY Space, Frindster &
sbgnya:
Social networking
www.http://
KEKERAPAN ANDA MEMBACA EMAIL?
frequency of reading own email?
SELALU / KADANG-KADANG / TIDAK
always/sometimes/no
ALAMAT RUMAH:
address
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