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  • Borang Penyertaan ISLC

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    Mohamad Ariff Makhfudz Al-Peraki
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    This document is a registration form for an international student leader conference. It requests personal information like name, contact details, religion, race, and educational details. It also asks about the applicant's involvement in associations and clubs and requires a signature to confirm the truth of the information provided.

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    This document is a registration form for an international student leader conference. It requests personal information like name, contact details, religion, race, and educational details. It also asks about the applicant's involvement in associations and clubs and requires a signature to confirm the truth of the information provided.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    7 views2 pages

    Borang Penyertaan ISLC

    Uploaded by

    Mohamad Ariff Makhfudz Al-Peraki
    This document is a registration form for an international student leader conference. It requests personal information like name, contact details, religion, race, and educational details. It also asks about the applicant's involvement in associations and clubs and requires a signature to confirm the truth of the information provided.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 2

    REGISTRATION FORM

    INTERNATIONAL STUDENT LEADER CONFERENCE Your Picture

    PART A
    Name : ……………………………………………………………………….
    I/C Number : ……………………………………
    Phone (h/p) : ……………………….
    Phone (Home) : ……………………….
    Email : …………………………………….
    Religious : …………………………………….
    Race : …………………………………….
    PART B
    College : …………………………………………………………………………
    Block : ………….
    Room : ………….
    Home Address : …………………………………………………………………………
    …………………………………………………………………………
    PART C
    Matrix : …………………………………………………………………………
    Year : ………….
    Course : ………….
    Semester : ………….
    Faculty : …………………………………………………………………………

    PART D

    Involvement in associations, clubs, JKM:


    1. _______________________________as__________________________ ( )
    2. _______________________________as__________________________ ( )
    3. _______________________________as__________________________ ( )
    4. _______________________________as__________________________ ( )
    5. _______________________________as__________________________ ( )

    PART E

    I hereby declare that all the information above are true. If the information provided is fault,
    this application will be rejected immediately.

    Signature

    ____________________________

    Name : ............................................................

    1|
    I/C : …………………………………………………

    Date : …………………………………………………

    2|

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