STUDENTS’ PERSONAL INFORMATION POLITEHNI ASIA LIAISON & INDUSTRIAL TRAINING UNIT vox MUKAH POLYTECHNIC, SARAWAK WICELY Wore Name bcNum, — : 2862 V3 CAG! — Address (Permanent/Temporary): oo Eee Reg.Num. ; 2SPEEICTISSS. AMQUSTEIL ESTATE (ees : House Num.: Health issue (If any) Phone Num. a sri Email _: MIskNwenaet SUBJECTS LEARNT IN MUKAH POLYTECHNIC, SARAWAK (AS PER CURRENT SEMESTER) LELECTRIONL MAC HIBE 3. POOLE ELECTRON 2. (MOL WIEGEMED CIRCUIT 4. wieELEecs S. PRosecy G- ewtrerpevtenip COMMON PIG N, WORKING EXPERIENCE / CURRENT KNOWLEDGE 1M MoTeR TRADIHG ¢, -— GEWEREL worktes KNOWLEDGE / EXPERIENCE NEEDED DURING INDUSTRIAL TRAINING LS WET Te AOD RY EVOWLEDGE BBOVT ELectmicAL a. WANT 5 TO SUITMBLE MYSELE WITH WoRte ESVIFO NMED] |, hereby declare that al the above statements contained in this form are true and correct. 210 .a4e D018 Students’ Signature = Date: 4. :