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  • BRG Deklarasi

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    Brg Deklarasi

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    7 views1 page

    BRG Deklarasi

    Uploaded by

    rpizrn

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    BORANG DEKLARASI PESERTA

    PROGRAM

    PERTANDINGAN PALUAN KOMPANG DAN FORMASI SEKOLAH MENENGAH PERINGKAT KEBANGSAAN 2013 2 HINGGA 4 SEPTEMBER 2013 BUKIT GAMBANG RESORT CITY, KUANTAN, PAHANG

    TARIKH TEMPAT

    : :

    Nama Penuh

    WAN MOHD FADLI BIN WAN FAUZI (mengikut Kad Pengenalan/Sijil Lahir)

    Alamat : No 6A, Kg Wang Besar, Jalan Tebing Tinggi, 01000 Kangar, Perlis

    No. Telefon : 017-5196037

    Jantina (L/P) : Lelaki

    Umur : 17 tahun

    Tarikh Lahir : 08.02.1996

    Pihak yang perlu dihubungi jika berlakunya kecederaan atau kemalangan

    Nama

    : WAN FAUZI BIN WAN SALLEH

    Hubungan

    : Ayah

    Alamat

    : No 6A, Kg Wang Besar, Jalan Tebing Tinggi, 01000 Kangar, Perlis

    No. Telefon

    No.Telefon Bimbit : 012-4366146

    17

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