You are on page 1of 2

SWIMMING ENTRY FORM

TEAM: SK CHENG H/P No: 017-6122963 TEAM MANAGER: EN.MOHD HAFIZ BIN HUSAINI Email: skcheng2029@gmail.com

MEN / WOMEN

GROUP: B12

No. Nama Peserta ( Huruf Besar ) Tarikh Lahir Event No. Event 1. TILLAI NAGATARRAN A/L 07-07-2004 203 50M BACKKSTROKE SARAVANAN 221 50M FREESTYLE 304 50M BREASTSTROKE

Best.Time -

2.

ASHOK KUMAR A/L SARAVANAN

20-10-2005

203 221 304

50M BACKKSTROKE 50M FREESTYLE 50M BREASTSTROKE

1. Please use separate forms for Male and Female. 2. Entries may be submitted by hard copy via Fax to Or email to skkerubong@gmail.com (preferred method) 3. Closing date for entries is

EN.MOHD HAFIZ BIN HUSAINI Team Manager Signature & date Email: skcheng2029@gmail.com

You might also like