Malaysia Robotics Gamez 2013
Line Follower Robot Competition - Build your own line follower robot using any products or materials !!
Sign in to Google to save your progress. Learn more
Part A: Payment Details
You can only proceed to register online after you had made the payment via bank-in / online banking.
Payment shall be made to:
NAME    : MYROBOTZ ENTERPRISE
A/C NO.: 5123 6116 2860
BANK    : MAYBANK  

Registration Fees:
- Preview Competition School Category (Age 7 - 17 years old)

Email the scanned transaction slip (or screen capture of the online confirmation) as proof of payment to secretariat@myrobotz.com.my & we will confirm the payment via sms within 3 working days.

In the email, please key in your TEAM NAME. Choose a short name to represent your team's name. __NOT MORE THAN 5 LETTERS__ eg: UTN01 is acceptable, but UNITEN01 is NOT!!
Payment Method *
Part B: Team Details
Category *
Please choose a category
State *
Please choose a state
Team Name *
Choose a short name to represent your team's name. __NOT MORE THAN 5 LETTERS__ eg: UTN01 is acceptable, but UNITEN01 is NOT!!
Mailing Address *
Please provide a valid mailing address for certificate delivery purposes
Part C: Instructor's Details
Name *
Instructor must be an adult
Contact Number *
Example: 012-3456789
Email Address *
Please provide a frequent used email address
IC Number *
Example: 000000-00-0000
Part D: Team Member 1 Details
Member 1 Name *
Contact Number *
Example: 012-3456789
IC Number / Birth Cert. *
Email Address (optional)
Please provide a frequent used email address
Part E: Team Member 2 Details (Optional)
Member 2 Name
Contact Number
Example: 012-3456789
IC Number / Birth Cert.
Email Address (optional)
Please provide a frequent used email address
Part F: Team Member 3 Details (Optional)
Member 3 Name
Contact Number
Example: 012-3456789
IC Number / Birth Cert.
Email Address (optional)
Please provide a frequent used email address
Acknowledgement
I hereby declare that I have been given the rights from the proper authority to register this team. I also acknowledge that by submitting this form, I bound myself & the team to the rules & regulations of Amphibious Electric Vehicle Competition set by the organizers. I also declare that all the information given in this form is true as far as I know. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms