BAHAGIAN PENGURUSAN AKADEMIK No.

Borang: BPA/K3
PEJABAT TNC (A&A) Edisi : 1
Tarikh Kuatkuasa :
KEBENARAN WAKIL MENGAMBIL PAKAIAN 19/08/2014 Muka Surat : 1
KONVOKESYEN BAGI PIHAK GRADUAN
AUTHORIZATION FORM FOR THE COLLECTION OF
CONVOCATION ATTIRE ON BEHALF GRADUATE

BORANG K3 / FORM K3
MAKLUMAT GRADUAN Graduate’s Particular

Nama Graduan ……………………………………………………………………………………………………………..

Name of Graduate

Nombor Kad Pengenalan/Paspot ………………………………………………………………………………………

Identity Card/Passport Number

Nama Program ……………………………………………………………………………………………………………..

Program……………………………………………………………………………………………………………...

Tahun Konvokesyen …………………………

Year of Convocation

Saiz Jubah : □S □ M □ L □ XL □ XXL

Dress Size :

MAKLUMAT WAKIL Representative’s Particular

Dengan ini mewakilkan penama di bawah mengambil pakaian konvokesyen bagi pihak saya:
I authorize the person below to collect my convocation dress on my behalf:

Nama Wakil …………………………………………………………………………………………………

Name of Representative

Nombor Kad Pengenalan/Paspot ……………………………………………………………………………………….

Identity Card/Passport Number

Hubungan ……………………………………………………………………………………………………………………
Relationship

PERAKUAN GRADUAN Graduate’s Consent

………………….. ……………………………….
Tandatangan Graduan Tarikh : ………………………..
Graduate’s signature Date

MAKLUMAN Note:

Borang ini hendaklah dibawa oleh wakil bersama sesalinan surat jemputan dan sesalinan slip bayaran semasa
mengambil pakaian konvokesyen.
This form, together with copies of the invitation letter and payment slip, should be brought along by the
authorized representative when collecting the convocation dress.

Wakil hanya dibenarkan mengambil dua (2) set pakaian konvokesyen sahaja (termasuk untuk diri sendiri) dalam
satu masa.
A representative is allowed to collect only two (2) sets of the convocation dress (including one for himself) at one
time