REGISTRATION & PAYMENT REGISTRATION FORM UPMHOLDINGS

UPM Education & Training Sdn. Bhd.

GST NO :002005909504
Programme RM √ Company Name : ..........................................................................
1 Fire Extinguisher Course 700/pax*
Address : ..........................................................................
(Theory & Practical)
2 Examination 318/pax* ...........................................................................................................
(Theory & Practical)
3 Practical Examination 212/pax* Office No. :............................... .. HP No.:..........................................
Repeat
FIRE EXTINGUISHER
(Note (*) All price are effective on 1 September 2018 Fax. No. : .............................. ... Email :........................................... COMPETENT PERSON
Participants must submit the Registration and full payment Participants COURSE
of fees before course commencement. No Name I/C No. HP 2019
Registration form submitted without the corresponding
registration fees will not be accepted. Seats will be Mandate by :
guaranteed only on prior registration with full payment.
Please specify preferred date of session and location
All fees must be made payable in advance to Programme Session Date
“UPM Education & Training Sdn. Bhd.”
Fire Extinguisher Course 2019
Bank Detail:
CIMB Bank Berhad
Branch of Universiti Putra Malaysia Examination (Theory & Practical)
43400 UPM Serdang, Selangor.
A/C No. 8002167906
Total Registration Fees:
Please contact the Secretariat for further information: Cheque No./Receipt No. .............................................enclosed for
the sum of RM......................................being registration fees for FIRE & RESCUE DEPARTMENT MALAYSIA
UPM Education & Training Sdn. Bhd. the course.
Training Unit
Block D, UPM-MTDC Technology Centre
Supported by :
I/We understand that my/our registration is subjected to the
Universiti Putra Malaysia following conditions:
43400 Serdang 1. The fees are not refundable. However substitution of
Selangor Darul Ehsan. participant will be accepted.
Phone No. : 03.8959.3408 2. Organizer will not be responsible for any refunds like flight
Fax No. : 03.8959.3409 ticket, accommodation or any cost if you still do make
Email : upmet.training@gmail.com arrangements before confirmation letters are sent out. The
organizer reserve the right to postpone/cancel the training or
Malaysian Fire Protection Association change the programme without prior notice .
No. 25-4, Block H 3. Registration is only accepted upon full payment of fee 2 week
Jalan PJU 1/37, Dataran Prima before the training. MALAYSIAN FIRE PROTECTION ASSOCIATION
47301 Petaling Jaya 4. Results will be notified via email within two (2) weeks after the
Selangor Darul Ehsan. exams.
Tel.:03-78049141 Fax: 03-78044592 5. Certificates will be issued two (2) weeks (14 working days)
Email: office@mfpa.com.my after receiving results.
 OBJECTIVE TENTATIVE PROGRAMME SCHEDULE 2019
To ensure that each participant has the competency in the selec-
tion, installation, servicing and maintenance of portable fire extin- Day 1 SEMINAR & THEORY EXAMINATION
guisher and qualified to be registered as a competent person in the
eFEIS with Fire And Rescue Department Malaysia (FRDM).
08:30—09:00 Registration SESSION
SESSION DATE LOCATION
Requirement for Fire Extinguisher Course 09:00—10:00 Introduction to Portable Fire Extinguishers NO
PM. Ir. Dr. Nor Mariah Adam (UPM)
 Age between 18 - 65 years old
10:00—10:30 Break 1. 22-23 FEB 2019 UPM
 Physically & mentally fit 10:30—12:30 Electronic Fire Extinguisher Inspection System
(eFEIS) 2. 26-27 APR 2019 UPM
 Participants must bring their own safety equipments (goggle, Fire and Rescue Department Malaysia (FRDM)
mask, glove, safety boot) 12:30—14:30 Break 3. 5-6 JUL 2019 UPM
14:30—15:30 Specifications for Portable Fire Extinguishers
Malaysian Fire Protection Association (MFPA) 4. 15-16 NOV 2019 UPM
Requirement for application of Competency Examination
15:30—17:30 Maintenance of Portable Fire Extinguishers
 A Malaysian Citizen (MS 1539: Part 4:2004)
Malaysian Fire Protection Association (MFPA)
 Age between 18 - 65 years old 17:30 End of First Day
 Minimum educational qualification—Pass SPM or equivalent
PRACTICAL EXAMINATION
 Has attended Fire Extinguisher Course. Day 2
SESSION
SESSION DATE LOCATION
 Physically & mentally fit NO
09:00—09.25 Registration
 Possess two (2) years working experience in servicing port- 09.25—10.30 Theory Examination 1. 24 FEB 2019 UPM
able fire extinguisher 10.30—12.20 Servicing and Maintenance of Portable Fire
Extinguishers (Practical Session) 2. 28 APR 2019 UPM
 Possess sufficient knowledge and skill in servicing of portable
fire extinguisher. 12:30—14:00 Break
14:00—18:00 Practical Session Continues 3. 7 JUL 2019 UPM
 Participants must bring their own safety equipments (goggle, 18:00 End of Second Day
face mask, glove & safety boot) 4. 17 NOV 2019 UPM

 Participants must bring the following documents for

verification purposes:
1. Identity card;
2. SPM certificate or equivalent;
3. Certificate of Companies Commission of Malaysia
(SSM) / Form 9 &49/Business Registration Certificate
(including attachment information current business
owner) if the participant is the owner of the company
OR
4. Certificate of Registration of Employer (KWSP 19) /
latest three (3) months EPF contribution by the
employer, Latest two (2) years EPF Member’s Account
Statement if participant is not the owner of the
Company.
 Candidates who failed in the examination (theory and/or
practical) will be allowed to repeat the examination within two
(2) years .
Examination Day
08:30—09:00 Registration
09:00—09:15 Briefing for Examination (Theory and Practical)  Please note there is a minimum requirement of 45 partici-
pants registered per session in order for the exams to run.
09:15—13:30 Examination (Practical) If the minimum number of required participants is not met
13:30—14:00 Break for a specific date those registered will be automatically
added to the next available course date.
14:00 – 18:00 Examination (Practical)  Confirmation letter will be sent out when
18:00 End of Session everything is confirm. Organizer will not be
responsible for any refunds like flight ticket,
accommodation or any cost if you still do make
arrangements before confirmation letters are sent
out. The organizer reserves the right to postpone/
cancel the training or change the programme with-
out prior notice .
Kindly browse through our website for further information
http://www.upmet.upm.edu.my/kursus
UPMHOLDINGS
UPM Education & Training Sdn. Bhd.
Syarat - syarat Kursus
Fire Extinguisher Competent Person 2019
 Peserta perlu mempunyai kelayakan akademik
sekurang-kurangnya lulus Sijil Pelajaran Malaysia
(SPM) dan setaraf atau kelayakan yang lebih tinggi
seperti sijil program pengajian yang diiktiraf
(Diploma/Ijazah) serta membawa sijil asal semasa
sesi pendaftaran.
 Peserta perlu mahir dan mempunyai pengalaman
bekerja sekurang-kurangnya dua (2) tahun
berkaitan dengan kerja-kerja penyelenggaraan alat
pemadam api mudah alih. Kriteria pengalaman
bekerja adalah suatu yang subjektif dan pihak kami
tidak meletakkan sebarang pengukuran dan
penilaian terhadap pengalaman tersebut. Ianya perlu
ditafsirkan sendiri oleh syarikat dan peserta yang
terlibat. Peserta perlu melampirkan i) Sijil
pendaftaran syarikat (SSM)/Borang 9 & 49/Sijil
Pendaftaran Perniagaan (termasuk lampiran
maklumat pemilik perniagaan terkini) jika peserta
merupakan pemilik syarikat; ATAU ii) Sijil
Pendaftaran Majikan (KWSP 19) / Penyata caruman
majikan bagi tiga (3) bulan terakhir DAN penyata
caruman ahli KWSP 2 tahun terkini jika peserta
BUKAN pemilik syarikat.
 Sekiranya peserta masih ingin mengikuti kursus ini
walaupun tidak mahir dan tidak mempunyai
pengalaman bekerja yang mencukupi, pihak syarikat
dan peserta perlu menanggung risiko sendiri
sekiranya peserta gagal dalam ujian teori atau ujian
praktikal. Selain itu, peserta juga mungkin
menghadapi masalah untuk berdaftar sebagai
"Competent Person" dengan JBPM yang
meletakkan kriteria berpengalaman dalam
penyelenggaraan APA sebagai satu syarat
penilaian. Pihak kami tidak akan bertanggungjawab
sekiranya peserta tidak layak untuk berdaftar
sebagai ‘Competent Person ‘dengan JBPM.
 Umur peserta yang dibenarkan untuk Saya memahami dan bersetuju dengan
mengikuti kursus ini adalah 18 hingga 65 syarat -syarat yang telah ditetapkan
tahun sahaja dan sihat tubuh badan. bagi mengikuti kursus di atas.
Sekiranya umur peserta melebihi 65 tahun, Sekiranya saya melanggar peraturan
peserta perlulah mendapat pengesahan dan terma yang telah ditetapkan maka
daripada Pegawai Perubatan Kerajaan yang
pihak UPM Education & Training Sdn.
mengesahkan bahawa tuan/puan berada
dalam keadaan sihat dan mampu untuk Bhd. boleh membatalkan penyertaan
melakukan kerja berat. dan tidak perlu memulangkan yuran
yang telah dibayar. Sebarang perkara
 Para peserta perlulah boleh membaca dan yang berlaku melibatkan kesihatan dan
menulis di dalam Bahasa Melayu atau kemalangan atau kecederaan sewaktu
Bahasa Inggeris bagi mengikuti kursus dan menghadiri kursus dan menjalani ujian
ujian yang akan dilaksanakan. teori serta praktikal adalah dibawah
risiko dan tanggungan sendiri dan saya
 Para peserta mestilah mempunyai peralatan tidak akan menyalahkan pihak
asas keselamatan yang perlu dibawa sebagai
penganjur.
alat perlindungan keselamatan diri seperti
"safety shoes", "goggle", "mask" dan "gloves"
semasa kursus dijalankan.
 Yuran bagi mengikuti kursus ini ialah
RM700.00 dan RM318.00 untuk mengambil Tandatangan Peserta
peperiksaan (termasuk SST).
 Sekiranya peserta gagal dalam ujian yang
_____________________________
dijalankan, para peserta perlu mengulang
(repeat) ujian tersebut pada siri kursus yang
akan datang. Yuran bagi ujian ulangan Nama :
adalah RM106 (Ujian Teori) dan RM212
(Ujian Praktikal). Ujian ulangan akan
No. K/P :
dilaksanakan pada hari peperiksaan yang
akan datang.
Tarikh :
Cop Syarikat :