ENTRY FORM

Participant ’s Name

IC No / Passport

Age

Mobile Phone

Address

City / State Postcode

Email:

College / University/ Company

Student ID/Designation

Course/Discipline

Project Title

Number of
Presentation Board

Mentor Name

DISCLAIMER

By participating in the Daikin Youth Design Competition, I______________________ have read and agree to be bound by the contest’s
official rules. I acknowledge that all information contained in this entry is accurate and that the entry will be disqualified if it fails to meet
any of the requirements detailed in the entry documentation. I also declare that I understand and agree to the terms and conditions of the
Awards and shall not hold Daikin Malaysia responsible in any way regarding my submission.

Name:

Date: