Kmc2016 School Registration Form

8/18/2019 Kmc2016 School Registration Form

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REGISTRATION FORM

KANGAROO MATH COMPETITION (KMC) 2016 Jointly Organized by KM Malaysia & Association Kangourou sans Frontière (AKSF), France

INSTRUCTIONS

1)

2) IMPORTANT

)

!)

") #ou $ay %ee t'e 'ardcoy or your on record*

+) e ill rely it' a registration con-r$ation it'in or%ing days* SMK Hulu Kelang.xlx

.) /'e deadline to sub$it t'e registration or$ and ay$ent is on 2. February 201+* $ail SubectKMC2016 REGISTRATION FORM

HO$ TO FI"" IN THE FORM%

1)

2) IMPORTANT

)

!) For non3Malaysian citizens, it is not re4uired to -ll in t'e 56*7* 8o*5 -eld*

&UESTIONS%

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= SCHOO" INFORMATION ' PERSON IN CHARGE

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/AMA8 S>6 ?A>/AMAS

K@AA 6MB@>

K@AA 6MB@>

IMPORTANT

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H "IST OF PARTICIPANTS

ON" teac'ers:lecturers s'ould sub$it t'is registration or$*

SAE t'e or$ in *.xl or *.xlx or$at*

EMAI" t'e co$leted or$ to +n,-/anga--a3.4-.5 Blease saIe as !43--l nae#.xl nae#.xlxO NOT sub$it t'e 'ardcoy o t'is or$*

e*g* SMK Hulu Kelang.xl or

@se CAPITA" "ETTERS to -ll in =, H &

Blease -ll in t'e 7"UE cells only*

RE cells are auto generated -elds* O NOT -ll any Ialue Ma%e sure t'e articiantsL na$es acorrectly*

inoG%angaroo$at'*co$*$y

S7?OO 8AM : NAMA SEKOLAH:

ACC>SS : ALAMAT:

BOS/7OC : POSKOD:

76/# : BANDAR:

S/A/ : NEGERI:

B?O8 8@ME> : NO. TELEFON:

FA 8@ME> : NO. FAX:

/'e Berson in 7'aresonsible or sacontest ac%age aad$inistering t'e

F@ 8AM : NAMA PENUH:

MOE6 B?O8 8O*:NO. TELEFON BIMBIT:

MA6 ACC>SS : ALAMAT EMEL:

mailto:[email protected]

mailto:[email protected]



BAS S7>O CO8

NUM7ER OF PARTICIPANTS ' PAMENT

B> 7O6>9N 1

7O6>N9 1

E8JAM68N9 7AC/N9 0 IMPORTANT

J@86O>N9 0 NAuto generated -elds*

S/@C8/N9 0

/otal no* o articiantsN9 22

Bay$ent er student (>M)N9 0*00

Sub /otal (>M)N9 ++0*00

S/ (+P)N (S/ 8o 9 001!+.121++!)9 ;*+0

TOTA" PAMENT (RM)*8 699.60Bay$ent Met'od 7ode (see belo)9

Bay$ent Cate9

>eerence 8u$ber (see belo)9

COE METHO REFERENCE NUM7ER E:AM

CH& 7'e4ue 8a$e o ban% & c'e4ue no* (searate by co$$a i $ore t'an one) Bay$ent 7ode9

MO Money Order MO nu$ber (searate by co$$a i $ore t'an one) >eerence 8o9

PO Bostal Order BO nu$ber (searate by co$$a i $ore t'an one)

EFT Ean%3in:lectronic Fund /ranser /ransaction reerence nu$ber (lease e$ail transaction sli)

"O Besanan Se%ola':Keraaan Cocu$ent nu$ber

7ANK ACCOUNT INFO

Account 8a$e9 ARENT EUCATIONA" CONSU"TANTS SN 7H Bre3Sc'ool

Account 8u$ber9 ;60021<;=6 BriIate : 6ntLl

8a$e o Ean%9 Bre3@ : 7ollege

IMPORTANT >

?

?

?

NO. SCHOO"* NAME

ST. FORM GRAE@EAR

e*g* 6M 7?O8 6 M 10.1!3103"!11 "

1 SKS? ACAM E68 K?A6>@ FA6D M 0"010310300" "

2 SKS? AMMA> E68 K?A6>@ FA6D M 00+031031;" 2

SKS? 8@>@ A#A E68/6 S#AK6>A? E68/6 S@A6MA8 /A8 F 0.00231+300.

! SKS? SA>A A88 DA68 F 0!013;13001+ +

" SKS? 8O>A E/? DA68 F 0+0113;1300! !

+ SKS? M@?AMMAC A6F 6Q?A8 E68 MO?C ?6DA6D6 M 0+0+0231030.1. !. SKS? 8@> AM6S#A ?A86SSA E68/6 MO?C D@8A66 F 0.02213030."0

SKS? M@?AMMAC AFF6Q A>FA8 E68 MO?C #@SMAC6 M 0.01"3030"""

; SKS? A6M# @MA#MA? E68/6 AEC@ AD6D F 0.112031!31.+

CIM7 Ila+4 7an/ (/a$an Canau Kota branc')

All ay$ent s'ould be ayable to ARENT EUCATIONA" CONSU"TANTS SN 7H

NOT to KM7 or KA8A>OO MA/? 7OMB/6/6O8*

GENER(F @ M)

IENTIT CAR(I.C) NO.

MA"ASIANSCHOO"

OTHERINSTITUTION



10 SKS? ?A86#? ?O@SSA686 M 0.02;31030!

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12 SKS? 8@> A/6KA? E68/6 DA6C6 F 0.00231031.!

1 SKS? >AC68 M6DA8 E68 >AC68 MADA8 M 0.0!231!30!""

1! SKS? >A##A8 C?A86A E68 MO?C K?A6>@C68 M 0.12231030+"1

1" SKS? 86K MO?AMC A6MA8 E68 A?MAC >#AC M 0.00310320.1 1+ SKS? MA?M 8AAD E68/6 EAEA> S?A?DAC F 0.11131!30+2

1. SKS? CD6#A@ AFFA8 E68 CD6#A@ AFC?A M 0.0;231031;;

1 SKS? M@?AMMAC >6CD@A8 E68 K?A6>@ A8@A> M 0.0.2231!310!.

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20 SKS? A6C8 6SSAA7 JA8 M 0.0;2;31!30!.

21 SKS? /?A8 EAB/6S/ 8A/?A8 M 0"0"2131!30. "

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IMPORTANT

CATEGOR* AMOUNT*

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B> 7O6> >M0*00

7O6> >M0*00

E8JAM68 >M0*00

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7O6> >M0*00

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7O6> >M0*00

7O6> >M0*00

7O6> >M0*00

7O6> >M0*00

E8JAM68 >M0*00

7O6> >M0*00

























Documents

Kmc2016 School Registration Form