ICDL COURSE REGISTRATION FORM – FULL TIME

COMPANY NAME HRDF CODE

ADDRESS
TEL NO FAX NO
CONTACT PERSON EMAIL
Please choose preferred intakes
INTAKE #1: 3 MAY – 12 MAY 2010
NO PARTICIPANT’S FULL NAME IC NUMBER DESIGNATION INTAKE #3: 5 JULY – 16 JULY 2010
INTAKE #5: 20 SEPT – 1 OCT 2010
INTAKE #7: 1 NOV – 13 NOV 2010
1 1 2 3 4 5 6 7
x
2 1 2 3 4 5 6 7

3 1 2 3 4 5 6 7

4 1 2 3 4 5 6 7

5 1 2 3 4 5 6 7
*For intake details, please refer to ICDL TRAINING SCHEDULE attached.
CANCELLATION
PAYMENT  A penalty of 25% will be imposed for cancellation.
Fee Per Pax No. of Pax Total Cancellation must be made no later than 3 days
SME Corp Grant RM 400 _______ x = prior to commencement date.
SSTC Member  Fees will not be refunded if participant fails to
Normal RM 2,000 _______ x =
For Companies show up on any day.
Non-SSTC SME Corp Grant RM 500 _______ x =
Member Normal RM 2,500 _______ x =
OTHER INFO
RM 2,500 (for 5 modules) _______ x =
Individual  Classes are from 9.00am – 5.00pm daily/Fri&Sat.
RM 500 (per module) _______ x =
 Please register your name at 8.30am on the first
TOTAL AMOUNT
day of the course.
Payment Method: Please enclose a crossed cheque to Sabah Skills & Technology Centre one week before the date of commencement.
 Participants are expected to attend the entire
Approved by COMPANY CHOP course to be eligible for examination and
certification.
Name:  Participants will receive reference materials upon
Designation: commencement of class.