KELAB PENEMBAK BANDAR DI RAJA KLANG IP : 016-208 8877 Lot. 4417, Batu 2%, Jalan Paip, Pekan Meru, 41050 Klang, Selangor D.E. BORANG PERMOHONAN MENJADI AHLI APPLICATION FORM FOR MEMBERSHIP (Sita gunakan huruf becar / Please use Mock tetters) ‘ax : 03-3342 6025 GAMBAR _. | 2. No. Kad Pengenalan [Tama Bare RAC No ond New 4. Kewarganegarsan 4. Jantian [“Lelaki/ Porempuan Nationality Gender Mole/ Female S. Tarik Labir (fari/Bulan Tahun) Date of Birt Wey/Month/Year) 6, Tempat Lanir Place of Birth 7 Pekerjaan Occupation aaa 8, Alamat Surat-Menyurat Correspondence Address Office ‘House 9 Alamat Pejahat W.No. Tel. Pejahat Office Adénoss Office Tet. Na 12.No, Tel. Ramah House Tel. No 1H. Alamat Ruaiah House Address 13,No. Tel. Bimbit ‘Handpione No 14, denis Senjata Api yang pimntkt — [Jents Banta Thuran Taras firearms n Prossession | Tipe Make Catitre 15, No. Lesen Senjata Api “Wal basa Ordinary Member Gum Heence Xo. Yuran Kemasukan /Enirance Fee: RM S00 Yoran Tahuran ! Anal Subscription = RM. 180 16. Hayaran [Tunak > CaENO. Associate Member Pasment |_Cash/* Cheque Nox Yuran Kemasukan/Enance Fee: RM_ 800 ‘uran Tahunan [neal Subseriotion + RM fadiuhaendt Yoran Tahuran lnnea Sbseron + RM 180 Yuran Kemasukan /Zneace Fee RM 3.000 Yuran Tshunan [Annual Subscriprion + tiada In * Cekscek harus dipalang dan dibayar kepada " Kelab Penembak Bandar Di Raja Klang” + Cheques are tobe crossed and made payable to "" Kelab Penemtbak Bandar Di Reja Klong” Sila sertoknn Dersama /Ploase enclose with the form: 1) ham keping gambse berukuran pesport Six copies of pusport sized photographs. 2) Satu slinan fotostat Kad Pengeralan slau Paspot One phavacopy of N.RI.C. or Passport.KELAB PENEMBAK BANDAR DI RAJA KLANG. ‘Lot 4417, Batu 2%, Jalan Paip, as Pekan Meru, 41050 Klang, Selangor D. B enueneiie bate hia HIP: 016-205 8877 Fax: 03-3342 6025 Rect eceoace ef al meberiipppicsbon be pijer io venegend angry erst Sihocsndtic Mecpanne Cones Tuan /$i0, ovat Rinses masa, rmengdtbara megan cuoentsthen mghniba usp senteiagwasales Tre Maapenent Commate reserve Berge Denwan ini say memohon menjadi ahli Kelab Penembak Bandar Di Raja Klang. | rec. recon napentor ee I hurcby apply to bscomea member of Kolb Perambsh Bandar Di Raja Klang, rey eee Perrot ADIL Application For Mensbershi Men Sho inn ash 3 anyone ‘ala permchonan aya disins, yabretjamemaht eplsimingandanedan | Sevurcxeg’nawvina nn ts cope peraturinKelab yang akan diterbithan das masa he maa Sa cena ny eppticatin's cepted, Logo to cb el a andre oth Chiba pubis rom | hi mi age of) Boag Permohonsn Mfenju A teh sap sap idan butiebusr yang say her aalsh benae da eepet epanjong pengeiahian saya Thave completed filling inthe Applicaion Form For Membership aru tothe best of my krowiedg, all aformation contaiveddhercn are ive and accurate Sckian terima kash Thank yon Yang benar | Your fh (Tandatangan/Sigranee) bie Ld PENGAKUAK PENCADANG DAS PESVOKONG DECK ARATION BY PROPOSER AND SECONDER (CLUB MEMBERS ONLY) Kami yang mecandatangani di bawah ini mengsku bahawa permohonan trscbut adalat dikenali scara peribadi dan layak maja sli Kes, Wie tke understgned declare tha: the above appltcart is personally rewn to us and aft and proper person io eceame a member of ke Club, “Tondotangan Peacadang /Proposer'sSienanre # No. Keahlian / Mersbership No. # ‘Tandatangan Peayokong | Seconder' ‘No. Keahlian /Mensborchip No, 4 UNIUK KEGLNAAN RASMI / FOR OFFICIAL USE “Tarikh Penerimsaa Pernohonan /Dute of Recep! of Applicaton Peraihonan [ DITERIMA/DITOLAR] Tesikh are: Application |_ACCEPYED /REIECTE ‘Tandstangan Presiden | President’ Sunnature Catatan one