Seminar Presenter and Scrabble+Chess Players for ISSCO in ASEAN Youth Camp Malaysia 2019
Please fill in ONE(1) the form for EACH school.

Please visit https://www.sciencejohor.com and https://www.aeisa.org for more information an inquiries.
Your early response is much appreciated

Maximum Number of participants :
ASEAN : Two(2) person per event per school
SBP : One(1) person per event for SBP.

First and foremost, please fill in your valid email address, so we may send registration approval copy to you.

Email address *
1.0 Nationality *
2.0 School's / Institution's Name *
Your answer
2.1 School's / Institution's email address *
Your answer
3.0 Teacher's / Matron's Full Name *
Your answer
3.1 Teacher's / Matron's Gender *
3.2 Teacher's / Matron's I/C No. @ Passport No. *
Your answer
4.0 Anyone from your school want to be the presenter in AYC International Seminar? If YES, please email your abstract to AYCM2019@sciencejohor.com *
4.1.0 Presenter 1 : Full Name
Your answer
4.1.1 Presenter 1 : I/C No @ Passport Number
Your answer
4.1.2 Presenter 1 : Gender
4.1.3 Presenter 1 : Highest Academic Qualification and Certification
Your answer
4.1.4 Presenter 1 : Title for Seminar Presentation or Research
Your answer
4.2.0 Presenter 2 : Full Name
Your answer
4.2.1 Presenter 2 : I/C No @ Passport Number
Your answer
4.2.2 Presenter 2 : Gender
4.2.3 Presenter 2 : Highest Academic Qualification and Certification
Your answer
4.2.4 Presenter 2 : Title for Seminar Presentation or Research
Your answer
5.0 Which competition that your school will participate? *
Required
5.1.0 Scrabble Player 1 : Full Name
Your answer
5.1.1 Scrabble Player 1 : I/C No. @ Passport No.
Your answer
5.1.2 Scrabble Player 1 : Gender
5.2.0 Scrabble Player 2 : Full Name
Your answer
5.2.1 Scrabble Player 2 : I/C No. @ Passport No.
Your answer
5.2.2 Scrabble Player 2 : Gender
5.3.0 Chess Player 1 : Full Name
Your answer
5.3.1 Chess Player 1 : I/C No. @ Passport No.
Your answer
5.3.2 Chess Player 1 : Gender
5.4.0 Chess Player 2 : Full Name
Your answer
5.4.1 Chess Player 2 : I/C No. @ Passport No.
Your answer
5.4.2 Chess Player 2 : Gender
6.0 SBP Participants : Do you need T-Shirt for souvenirs? Pre-order must be paid before June 23rd, 2019 (RM30.00/pcs OPTIONAL) *
6.1 Souvenir Tshirt 1 : Please tick all the variants
6.2 Souvenir Tshirt 2 : Please tick all the variants
6.3 Souvenir Tshirt 3 : Please tick all the variants
6.4 Souvenir Tshirt 4 : Please tick all the variants
7.0 Payment reference number (Telegraphic Transfer Receipt)
Your answer
7.1 Date of Payment
MM
/
DD
/
YYYY
Time
:
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service