MALAYSIA 2014 WORLD YOUTH STAMP EXHIBITION EXHIBIT APPLICATION FORM 1 - 6 DECEMBER 2014

Class 1 Yo !" P"#la!$l%
Fill in a separate form for each exhibit. Please print or type in block letters. This Exhibit Application Form must be returned through the Commissioners

Class 2 T"$&a!#' P"#la!$l% Class - Mo.$/+ P"#la!$l% 0o1 21s! C$+! /%2

to reach the Commissioner General by 11 April !1" at the address belo#$ Address c8o 0ak ?ok Cheong= .eputy Commissioner General= * @alan /3@ "810= "A&!! 3ubang @aya= 3elangor = 0alaysia Telephone Email %&! 1' '(!)!"* #orldyouth !1"Bgmail.comC lkcmakByahoo.com

First Time Entry $+es F-P -.E,T-T+ ,/01E2$ 0r 0iss Pseudonym Address

,o
Tel Fax Email

3urname .ate of birth 4for youth exhibitors5

First ,ame Telephone Email Fax

Title of this exhibit 4in English5

Pre6ious title

3hort description of the exhibit 4in English5

-ntroduction page included Exhibit class

+es

,o .imensions of sheets 4in cm5 1 PAST AWARDS RECEI(ED 9G A A7 17 : 93 3 31 1

,umber of frames applied for

-nternational F-AP8FEPA8F-AF8 ;orld 4F-P5 Exhibitions

G

9:

,ational Exhibitions

The undersigned 4Exhibitor5 hereby 415 agrees to accept all F-P 2egulations 4G2E<= G2E:= 32E:35 and the indi6idual regulations 4-2E<5 applying to 0A9A+3-A !1" 4 5 confirms that the exhibit is o#ned by me 4G2E< Article 11. 5 .ate Commissioner>s declaration 2emarks 3ignature

.ate E)"#*#!#o+ ($+ $,

3ignature ?uala 9umpur Con6ention Centre Exhibition Dall 1 E 4Address$ @alan Ampang= )!!(( ?uala 9umpur= ;ilayah Persekutuan ?uala 9umpur= 0alaysia5 The exhibit #ill be deli6ered by commissioner.

F/a&$ F$$s$ Class 1 FreeC Class E ' /3F)! per frame

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