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Lampiran 7 / Appendix 7

BORANG PENGESAHAN LAPOR DIRI PALS


PALS Rerpot Duty Form

Nama Pelajar / Student’s Name : NUR’AQILAH BINTI KAMARUZZAMAN_________________

No. Matrik / Matric No. : 206572_________________________________________

Program / Programme : BACELOR SAINS FIZIK DENGAN PENDIDIKAN (KEPUJIAN)

Nama dan Alamat Sekolah / : SMK BANDAR BARU SERTING __


Name and Adress of the School SMK BANDAR BARU SERTING, 72120 BANDAR SERI_____
JEMPOL, NEGERI SEMBILAN________________________

No Telefon Sekolah / : 06 – 4581849____________________________________


School Phone Number

Nama Guru Pendamping / : PUAN NORFADHILAH BINTI MUSTAFFA_______________


Guidance Teacher

PENGESAHAN SEKOLAH
SCHOOL DECLARATION

Saya mengesahkan pelajar ini telah melapor diri di sekolah ini.


I hereby declared that this student has reported in this school.

.................................
(Pengetua / Principal)
Cop Rasmi / Official Stamp

(Borang ini hendaklah disimpan sesalinan oleh pelajar. Student is required to keep of copy of the
form.)

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