TIGER MOTOR SPORT CLUB

(TMSC) 1 KEPING
GAMBAR
KAMPUNG KESAPANG SAIZ PASSPORT
JALAN KUDAT, PETI SURAT 215
89150 KOTA BELUD, SABAH

BORANG PERMOHONAN KEAHLIAN

1. NAMA : ..............................................................................................................................................

2. NO. IC : ..............................................................................................................................................

3. NO. PEND. KENDERAAN :.................................. JENIS/MODEL :.........................................................

4. TARIKH LAHIR : ...................................... TEMPAT LAHIR : .................................................................

5. KEWARGANEGARAAN : ......................................................................................................................

6. PEKERJAAN : .......................................................................................................................................

7. NAMA SYARIKAT/MAJIKAN : ..............................................................................................................

8. NO. TELEFON : (PEJ).................................. (RUM).................................. (H/P)...................................

9. ALAMAT : ...........................................................................................................................................

............................................................................................................................................

10. BERSAMA INI DISERTAKAN WANG TUNAI BERJUMLAH RM ..............................................................

YURAN KEMASUKAN (RM100.00) DAN YURAN TAHUNAN (RM50.00).

Saya berjanji akan mematuhi segala syarat dan peraturan-peraturan yang terdapat dalam
perlembagaan kelab ini dengan semangat perpaduan dalam kelab.

TARIKH : .................................................. ........................................................

(TANDATANGAN PEMOHON)

KEGUNAAN JAWATANKUASA
PERMOHONAN DITERIMA/DITOLAK ................................. NO.AHLI : TMSC/2023/.............

NOMBOR RESIT : ............................................................... TARIKH : .......................................

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(TANDATANGAN PENGERUSI)