ACCEPTANCE FORM

BRITISH MALAYSIAN INSTITUTE

BT. 8, JALAN SUNGAI PUSU,
53100 GOMBAK,
SELANGOR DARUL EHSAN

Industrial Training
BRITISH MALAYSIAN INSTITUTE
Academic session BMI 2020/2021 - 1 - July 2020 (24) from July 20, 2020 – January 1, 2021.

Student Name: FATIN SYAZANA BINTI ADNAN
from Bachelor of Engineering Technology (Hons) in Medical Electronics.

To be filled in by the company

Company Name /Address: HARTALEGA SDN BHD
(Company Official Stamp):

Telephone number: fax number:

Contact person:

Designation: Email:

We hereby (please tick)

Agreed: We apologize for unable to accommodate:
Students will be receiving the following facilities:
Monthly /weekly/daily training allowances (if any) RM:
Accommodation will/will not be provided:

Student Acceptance (to be completed by student)

Reminder, student’s final choice of company must be relevant to his/her program.Change of INTRA location is
not allowed after the signing of the acceptance form.

I have read and understood the above and with this

I, hereby (studentname):

Contact no: Email:

Student (please tick)

Agree: Decline:

Signature: Date:

For INTRA Office use only

PLEASE REPLY AND FAX THIS FORM TO BRITISH MALAYSIAN INSTITUTE by E-Mail(azita@unikl.edu.my) / Fax (03-6186
1722) not later than . Your cooperation is highly valued. Thank you.