EARLY REGISTRATION FORM

KANGAROO MATH COMPETITION (KMC) 2015

Jointly Organized by KMC Malaysia & Association Kangourou sans Frontire (AKSF), France
INSTRUCTIONS
1) ONLY teachers/lecturers should submit this registration form.
2) SAVE the form in *.xls or *.xlsx format.
3) EMAIL the completed form to info@kangaroomath.com.my
4) DO NOT submit the hardcopy of this form.
5) You may keep the hardcopy for your own record.
6) We will reply with a registration confirmation within 3 working days.
7) The deadline to submit the registration form and payment is 31 December 2014.
HOW TO FILL IN THE FORM?
1) Use CAPITAL LETTERS to fill in &
2) Please fill in the BLUE cells only.
3) RED cells are auto generated fields. DO NOT fill any value!
4) For non-Malaysian citizens, it is not required to fill in the "I.C. No." field.
QUESTIONS?
Call:
Fax:
Email:
Twitter:
Facebook:

IMPORTANT
Please save as <school name>.xls or <school
name>.xlsx
e.g. SMK Hulu Kelang.xls or
SMK Hulu Kelang.xlsx
Email Subject
KMC2015 REG FORM <SCHOOL NAME>

IMPORTANT
Make sure to double check the spelling for each
details.

03-41317672
03-41490572
info@kangaroomath.com.my
twitter.com/kangaroomathMY
facebook.com/KangarooMathMalaysia

SCHOOL INFORMATION & PERSON IN CHARGE

SCHOOL NAME / NAMA SEKOLAH:
ADDRESS / ALAMAT:
POSTCODE / POSKOD:
CITY / BANDAR:
STATE / NEGERI:
PHONE NUMBER / NO. TELEFON:
FAX NUMBER / NO. FAX:
TITLE (EN./PN./MR./MRS./MS./MISS/MDM.):
FULL NAME / NAMA PENUH:
IDENTITY CARD (I.C) NO:
PHONE NUMBER / NO. TELEFON:
EMAIL ADDRESS / ALAMAT EMEL:
NUMBER OF PARTICIPANTS & PAYMENT
Total no. of expected participants*:

IMPORTANT
The Person in Charge is
responsible for safeguarding the
contest package and
administering the contest.

Payment per student (RM)*:

TOTAL PAYMENT (RM)*:
Payment Method Code (see below):
Reference Number (see below):
CODE
CHQ
MO
PO
EFT
LO

METHOD
Cheque
Money Order
Postal Order
Bank-in/Electronic Fund Transfer
Pesanan Sekolah/Kerajaan

27.00

0.00

REFERENCE NUMBER
Name of bank & cheque no. (separate by comma if more than one)
MO number (separate by comma if more than one)
PO number (separate by comma if more than one)
Transaction reference number (please email transaction slip)
Document number
BANK ACCOUNT INFO
ARDENT EDUCATIONAL CONSULTANTS SDN BHD
8600213876
CIMB Islamic Bank (Taman Danau Kota branch)

Account Name:
Account Number:
Name of Bank:
IMPORTANT
All payment should be payable to ARDENT EDUCATIONAL CONSULTANTS SDN BHD
NOT to KMC or KANGAROO MATH COMPETITION.

EXAMPLE
Payment Code:
Reference No:

ame>.xls or <school

CHOOL NAME>

the spelling for each

on in Charge is
ble for safeguarding the
ackage and
ering the contest.

EXAMPLE
CHQ
MBB 113111