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BORANG BORANG PENDAFTARAN PENDAFTARAN PASUKAN PASUKAN MSSM

R02

PERMAINAN/SUKAN : MERENTAS DESA NEGERI SEKOLAH

: SJKT LADANG MARY

JANTINA

:

Bil 1 2 3 4 5 6

Nama Pegawai VERASENAN A/L GUNASEKARAN

Nama Pemain

Bil 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

LELAKI

SRI MUGUNTHAN A/L RAJA SEGARAN DEVA A/L RAVINDRAN KOGULAN A/L MANIMARAN LOGA SHARMAN A/L ASOAK

KUMPULAN KUMPULAN UMUR: UMUR: L3

Jawatan

Sekolah

PENGURUS

SJKT LADANG MARY

No. Surat Beranak BV51543 BU56203 CJ32425 CJ31891

Sekolah SJKT LADANG MARY SJKT LADANG MARY SJKT LADANG MARY SJKT LADANG MARY

Mengesahkan bahawa segala maklumat yang dinyatakan di atas adalah benar seperti dalam borang R01.

Pengurus Pasukan Nama No. KP Tarikh :

Guru besar Cop Rasmi:

Tarikh :

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