SESSION 1 (Morning)

12 August 2017

REG-750-005-QR-01

2017 CONVOCATION ATTENDANCE REPLY FORM

MUHAMAD FATHI BIN MAHAMAD SUKRI

CE093660

Please fill in the form in TWO (2) copies. Kindly return the first copy to the Registrar's Office and
second copy for your record and safe keeping.

TO BE COMPLETED BY GRADUATE (please cross (X) where applicable)

The Convocation Ceremony will be held from Saturday until Monday, 12th 14th August 2017
with FIVE (5) sessions (morning and afternoon). The details will be finalized according to your
programmes. Click http://convocation.UNITEN.edu.my/ for details.

I hereby declare that, I will;

Attend Not Attend the convocation ceremony.

Signature : Date : 10/07/2017

UNITEN ALUMNI ASSOCIATION REGISTRATION

I AGREE to be a lifetime member of the UNITEN Alumni Association by paying

RM30.00 and will update my details at the link provided to receive my membership
ID and benefits from the UNITEN Alumni Association Membership Application Form

I DECLINE to be a lifetime member of the UNITEN Alumni Association

I agree to pay RM295.00 (inclusive of GST) for attending the UNITEN 20th
Convocation Ceremony and lifetime membership UNITEN Alumni Association.

I agree to pay RM265.00 (inclusive of GST) for attending the UNITEN 20th
Convocation Ceremony.

Please reply together with proof of payment on or before 24th July 2017 (Monday), by 4.30 p.m.
either by ;

Fax : +603-89287166 OR E-mail : academicreg@uniten.edu.my

Please show the receipt of payment to personnel on duty when collecting the convocation attire.