‘Booking Form/RGD'19/TNCP SPONSORSHIP BOOKING FORM UTM Royal Gala Dinner 2019 Kindly select ¥/ the package of your choice: [1 Premier (4 tables with 1 special seat each) RM 200,000.00/table Platinum (10 tables) RM 120,000.00/table [1 oid (15 tables) RM 60,000.00/table Silver (20 tables} RM 30,000.00/table =e (25 tables) RM 15,000.00/table PAA 7, BO? [J individual contribution RM shane bible wit UTSB: Name: TMH O24 Address HOLDINGS... ING._C Pb ock. 2 VERSITL TEKNOLCG | MALAYSIA. V SULTAN YAHYA. PETRR, F4)00. KuRLA, Lumpur Contact Ni we Aeon Payment can be made through: + Cash/cheque (cheque to be made to BENDAHARI UTM) 10 hehurs MBE DABLIE © Bank Draft (Ref. NO. uu a) + Deposit to UTM Account (CIMB 8006053536) + Debit/Credit Card (ecommerce.utm.my) Please send the cheque/deposit slip with this form using the attached stamped envelope ‘or email to the address stated below: RGD’19 Secretariat Office: ADVANCEMENT DIVISION c/o UTM Alumni House, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor Darul Ta'zim Tel : 07-5536002/9 (Miss Nisa/Ms Ema) Our liaison officers: En Jaffrey Samsul Bahrin (07-5531231), En Kamsaini Kamaruddin (07-5536210) En Baharuddin Mastari (07-5531043) :RGD19@utm.my website : www.utm.my/rovalgaladinner/,Resit Deposit Cek No Akaunikad $008.053536 Nama BENDAHARIUTH, Terie 01-Oct-2019 Nese sas0-11 Caw /Temiral 3514320_-VI70 NoU. Nega/Sii 0718/0027 Maybank Nombor Cex 099818 ID Bark 5414095 Bank Mays: Ringh umiah Ck suumian amaun 7,600.00 PERINGATAN KEPADA PELANGGAN-PELANGGAN:- icimenank Bicimpaank Bhcime sank cimeeank Bicimena