PESERTA-KURSUS-PENDEK.pdf - UKM

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BORANG PENDAFTARAN ALUMNI BERSEKUTU UKM PESERTA KURSUS JANGKA PENDEK

SHORT-TERM COURSE PARTICIPANT MAKLUMAT PERIBADI

PERSONAL INFORMATION

Nama Penuh Full Name

No. Kad Pengenalan IC No.

Alamat Address

No. Telefon Bimbit Handphone No.

Nombor Telefon 2 (jika ada) Phone No. 2 (if available) Alamat Emel

Email Address

Alamat Emel 2 (jika ada) Email Address (if available) Pekerjaan & Organisasi Occupation & Organization Alamat Organisasi

Organization Address

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BORANG PENDAFTARAN ALUMNI BERSEKUTU UKM PESERTA KURSUS JANGKA PENDEK

SHORT-TERM COURSE PARTICIPANT PESERTA KURSUS JANGKA PENDEK SHORT-TERM COURSE PARTICIPANT

Pernah menghadiri kursus jangka pendek di UKM?

Have you ever attended short-term course(s) in UKM?

Nama Kursus 1 Name of Course 1

Tempoh Duration

Anjuran

Organized by

Tempoh Duration

Anjuran

Organized by

Tempoh Duration

Anjuran

Organized by

Tempoh Duration

Anjuran

Organized by

Tempoh Duration

Anjuran

Organized by

Tempoh Kumulatif Kursus Cumulative Courses Duration Keterlibatan bersama Pusat Perhubungan Alumni UKM

Engagement with Centre for Alumni Relations UKM

Nyatakan Nama Program

Please Specify Name of Programme(s) Anda pernah menyumbang pada UKM?

Have you ever contributed to UKM?

Nyatakan jenis sumbangan anda Please Specify the Type of Your contribution(s)

□

Ya/Yes

□

Tidak/No

□

Ya/Yes

□

Tidak/No

□

Ya/Yes

□

Tidak/No

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BORANG PENDAFTARAN ALUMNI BERSEKUTU UKM PESERTA KURSUS JANGKA PENDEK

SHORT-TERM COURSE PARTICIPANT

Borang pendaftaran yang telah lengkap perlu dihantar ke:

Completed form can be sent to:

Pengarah

Pusat Perhubungan Alumni Universiti Kebangsaan Malaysia 43600 UKM Bangi

Selangor Darul Ehsan atau emel kepada:

or email it to:

[email protected]

Muat Naik Sijil Kehadiran/Kompetensi Upload Attendance/Competency Certificate(s)

Adakah anda berminat untuk menyumbang kepada UKM?

(sumbangan dalam pelbagai bentuk) Would you be interested to contribute to UKM? (Contributions can be in any forms)

Apakah bentuk sumbangan yang ingin diberikan?

What type of contribution would you like to give?

□

Ya/Yes

□

Tidak/No