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SMK KINARUT ALUMNI ASSOCIATION

SMK Kinarut , 86908 Papar Sabah, Malaysia
Tel: +6088 750181 Fax : +6088 750224

alumni_smkk@live.com

BORANG KEAHLIAN
(Membership Form, SMK Kinarut Alumni Association)

MAKLUMAT PERIBADI (PERSONAL PARTICULARS)

Tan Sri/ Dato’ Seri/ Datuk/ Dato’/ Datin/ Dr./ Ir./ Prof./ Prof. Madya/ Hj./ Hjh./ Tuan/ Puan/
Encik/ Cik *
Nama/ Name:_______________________________________________________________
K/P / NRIC:________________________ Angkatan Tentera / Polis:_______________
Jantina/Sex: *Lelaki/ Perempuan(Male/ Female)
Tarikh Lahir/ Date of Birth:_____________________
Status Perkahwinan/ Marital Status:*
Berkahwin/ Bujang/ Berpisah
Married/ Single/ Widow/ Separated
ALAMAT SURAT MENYURAT (CORRESPONDENCE ADDRESS):
Pejabat/ Office ___________________________________________________________
___________________________________________________________________________
Rumah/ Home _____________________________________________________________
___________________________________________________________________________
Pekerjaan/ Profession: _______________________________________
Jawatan/ Position:___________________________________________
No. Telefon : Rumah/Home____________________Pejabat/ Office_______________
Bimbit/ Mobile_____________________ E-mail___________________________________

LATAR BELAKANG PENDIDIKAN DI SMK KINARUT

(EDUCATION BACKGROUND IN SMK KINARUT)

Kelulusan (Qualification) Kelas (class) Tahun (Year)

YAR/alumni-SMKK2010/B01
PMR
SPM
STPM

* Bulatkan yang mana berkenaan (Circle the appropriate information)

BAYARAN KEAHLIAN (MEMBERSHIP FEES)

Ahli Seumur Hidup (Life Member)* - RM20.00

Di sini saya sertakan cek / wang tunai berpalang untuk bayaran yuran keahlian di atas nama “Persatuan
Alumni SMK Kinarut”.
(I hereby enclose a crossed cheque/cash for payment of the membership fees made payable to
“SMK Kinarut Alumni Association”
Bank:________________________________Cek No./ Cheque No.:___________________
Jumlah/ Amount:_____________________________
Tandatangan/ Signature:_____________________ Tarikh/ Date_____________________

Untuk Kegunaan Pejabat

(For Office Use)

Permohonan diluluskan/ Tidak diluluskan

Application Approved/ Not Approved

Tarikh/ Date:_______________

Presiden/ President Setiausaha Agung/ Honourable Secretary

Sila hantarkan Borang Keahlian dan Bayaran Kepada (Please send the Membership Form and
Payment to):

URUSETIA,
SMK KINARUT ALUMNI ASSOCIATION
SMK Kinarut , 86908 Papar Sabah, Malaysia
Emel: alumni_smkk@live.com

* Semua ahli persatuan di wajibkan melengkapkan surat akujanji dan mematuhi

segala perturan yang terkandung dalam perlembagaan pertubuhan.

YAR/alumni-SMKK2010/B01