*To be filled by the teacher in charge for participants with payment submitted BEFORE event

STUDENT REGISTRATION DETAILS FORM

BORANG PENDAFTARAN PELAJAR/MURID

Name of the school:

Head of the Institution Name: Teacher in Charge Name :

Head of the Institution Contact No: Teacher in Charge Contact Number :
PIBG/LPS Name:
PIBG/LPS Contact No:

No. Full Name NRIC Number Payment Package ( Please tick / )

RM30 (MBR) RM130 (MBR &
GBWR)