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Borang Pendaftaran CHOICE BM KL 6
CHOICE Bahasa Malaysia Kuala Lumpur
Email address *
Nama Penuh *
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Nama Panggilan *
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No. KP *
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Tarikh Lahir *
MM
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DD
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YYYY
Umur *
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Bangsa / Etnik *
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Jantina *
Status *
Pekerjaan (Sila isikan “Pelajar” jika masih belajar) *
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Agama *
Paroki di Semenanjung *
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Paroki di Sabah / Sarawak / Lain-Lain *
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Alamat di Semenanjung *
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Diet Khas / Alergik Jika Ada
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Perlu Pengangkutan (Dari “Pick-up Point” ke APC) *
Telefon Rumah
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Telefon Bimbit *
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Telefon Pejabat
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Perhubungan Kecemasan (Cth: Kane / Abang) *
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Nombor telefon perhubungan kecemasan *
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No. Telefon Ibu/Bapa/Penjaga *
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Alamat Ibu/Bapa/Penjaga *
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Disyorkan Oleh *
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