PERPUSTAKAAN UNIVERSITI MALAYA

BORANG PENDAFTARAN KEAHLIAN

Membership Registration Form

MAKLUMAT PERIBADI
PERSONAL INFORMATION
Nama :
Name :
Gelaran: No. Barkod Perpustakaan: No. Matrik:
Title : Library Barcode No. : Matric No.:
No K/P : No. Passport : Tahun Tamat Kursus :
IC No. : Passport No: Year of Completion :
Fakulti : Emel :
Faculty: Email :
Alamat Sesi :
Current Address :
Alamat Tetap
Permanent Address :
Nama Majikan :
Employer :
Alamat Pejabat
Office Address :
No. Telefon (HP) : No. Telefon (R) : No. Telefon (P) :
Telephone No (HP) Telephone No (H) Telephone No (O)