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*** PPB USM Alumni Reunion Dhamma Camp 2014 The Journey Home...
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Registration Form
Name
*
Your answer
Year of Graduation
*
Your answer
Email Address
*
Your answer
Corresponding Address
Your answer
Contact Number
*
Your answer
Gender
*
Male
Female
Required
Accompanying Children
*
Accompanying children must be above 7 years old. Forms for these kids' registration will be released later.
Yes - 1 child.
Yes - 2 children
Yes - 3 children
Yes - 4 children
No
Required
What do you expect from this camp?
Your answer
Do you have t-shirts from the previous camp? If no, do you want to buy one?
Your answer
Any health issue? If yes, please state. Thank you.
Your answer
Any other specific needs or request? (Eg. transportation, special diet etc)
Your answer
Payment to:
Registration Fee: RM60
Bank-in Account:
Public Bank
Tan Chin Min
Acc No: 4638454603
Please inform Chin Min via SMS (0129548993) or email (
chin_min.tan@hotmail.com
) once payment is made. Thanks.
Closing Date:
30 October 2014
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