HAP SENG GROUP D-CODE: PROFILE FORMCAMP: 2DATE: 5-8 August 2015VENUE: SMK ELOPURA SANDAKAN

School Name: SMK ELOPURA 2,SANDAKAN

Student

No Full Name as in IC NRIC Number Age T-Shirt Size Contact Number (Parent)

1 MOHD AZRULSHAH BIN FAZEDUL SAFIL 001110-12-0965 15 M 0138531815

2 MUHAMMAD RIZAL BIN ABDULLAH SALLEH 000808-12-0399 15 XL 0138798582

3 SAFWAN ADLAN BIN JOHAN 000313-12-2093 15 L 0138803533

4 NUR AIN BT AZHAR 001224-12-0306 15 M 0138670057

5 AMYLIA NADIA BT SALSAIN 001219-12-1056 15 M 0178392980

Teacher

No Full Name as in IC NRIC Number Age T-Shirt Size Contact Number

1 ISMAIL BIN MOHAMED 840801-03-5759 31 L 0129089231

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.org.Thank you.