PERSATUAN TELUGU MALAYSIA

CAWANGAN RAWANG

(369/55-15)
No 55-2A, Jalan Bandar Rawang 1, 48000 Rawang, Selangor Darul Ehsan

FUTSAL TOURNAMENT FORM

TEAM NAME :
BRANCH :
CONTACT PERSON :
CONTACT DETAILS :
EMAIL ADDRESS :

No Name NRIC No Contact No

1
2
3
4
5
6
7
8

• All completed entry forms together with the cash must reach us by 31st March 2011.

Disclaimer :
We agree to abide the rules set by the organizers and release them any responsibility in the
event of untoward incidents that may befall the participants.

Signature :

Name :

Thank you.

Yours sincerely,
TAM Rawang { Youths & Mahilas }
Organizing Committee