HAP SENG GROUP D-CODE: PROFILE FORM

CAMP:
2
DATE:
5-8 August 2015
VENUE: SMK ELOPURA SANDAKAN
School Name: SMK ELOPURA 2,SANDAKAN
Student
No

Full Name as in IC

NRIC Number

Age

MOHD AZRULSHAH BIN FAZEDUL SAFIL

001110-12-0965

15

MUHAMMAD RIZAL BIN ABDULLAH SALLEH

000808-12-0399

15

SAFWAN ADLAN BIN JOHAN

000313-12-2093

15

NUR AIN BT AZHAR

001224-12-0306

15

AMYLIA NADIA BT SALSAIN

001219-12-1056

15

Teacher
No

Full Name as in IC

NRIC Number

Age

ISMAIL BIN MOHAMED

840801-03-5759

31

Are you an IT Teacher?

** Please return this form to the D-Code Secretariat by fax at 03 22827006 or email to sarah@startupmalaysia.org or shazlina@startupmalaysia

T-Shirt Size

Contact Number (Parent)

0138531815

XL

0138798582

0138803533

0138670057

0178392980

T-Shirt Size

Contact Number

0129089231

hazlina@startupmalaysia.org.Thank you.