SEKOLAH KEBANGSAAN SUBANG JAYA

JALAN SS14/5, 47500 SUBANG JAYA,

SELANGOR DARUL EHSAN.

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BORANG MAKLUMAT DIRI ATLET OLAHRAGA
SEKOLAH KEBANGSAAN SUBANG JAYA
MAKLUMAT MURID
NAMA

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NO K/P

: ___________________________ TARIKH LAHIR

KAUM

: _______________________

AGAMA

: _____________

: ___________________

TEMPAT LAHIR

: _______________________________________________________

ALAMAT

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SAKIT / ALAHAN

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NO TELEFON MURID (JIKA ADA)

: ___________________________________________

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MAKLUMAT BAPA / PENJAGA
NAMA BAPA/ PENJAGA : ____________________________________________________
PEKERJAAN : _______________________________ GAJI

: ___________________

ALAMAT TEMPAT KERJA : __________________________________________________

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NO. TEL BIMBIT

: ___________________ NO TEL PEJABAT : ___________________

MAKLUMAT IBU / ISTERI

NAMA BAPA/ PENJAGA : ____________________________________________________
PEKERJAAN : _______________________________ GAJI

: ___________________

ALAMAT TEMPAT KERJA : __________________________________________________

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NO. TEL BIMBIT

: ___________________ NO TEL PEJABAT : ___________________