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Course Booking Form

KGS Quality Action Limited.


House # 275/A, Road # 20, Mohakhali DOHS, Dhaka-1206. Bangladesh.
Phone: +88 02 48810309
Please return to: Fax: +88 02 48810310
Mobile: + 88 02 01706314222
Email: info@kgsqa.com
kgsdhaka@gmail.com
www.kgsqa.com

Course No. LAC 01 (You can find the Course number from Page No. 3 onwards)
* Course you wish to attend:
Title: Awareness Course on ISO 22000:2018 (FSMS)

Date:
* Full Name: SANJAY KUMAR PAUL
* Designation: MICROBIOLOGIST
* Company Name: YOKO FOOD & AGRO LTD.
* Address: Godarbag, Kalindi, Keranigong, Dhaka.
* Mobile No. 01917181657
* E-mail: sanjay.mb.jstu@gmail.com
Post Code:
* Tel No.
Fax No.:
Fish, Chicken & Vegetable.
Diet: (Please specify any special dietary requirements)

Disabilities: (Please inform us of any disabilities so that we can meet your requirements)

Declaration: I have met the course prerequisites Yes √☐ No ☐

Signature

Date 06-02-2019
Circle one. If you have not met the course prerequisites and still want to attend the course you can do so. By signing this application you
acknowledge that failing to have met the prerequisites you might not be able to achieve the learning objectives of the course and that you
do not expect extra coaching; you further acknowledge by failing to meet the pre course requisites you will be unable to successfully apply
for certification.

KGSC(B)L-01/06
Page 1 of 1
Effective 01.01.2016

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