SCOUTS MOVEMENT, SEKOLAH MENENGAH KEBANGSAAN DATUK HAJI AHMAD SAID, 13800 BUTTERWORTH, PULAU PINANG. _____________________________________________________________________

Scouts Movement Membership Form Section A: Personal Details

1. Name :Azman Bin Mohammad

2. Form :1 Amanah

3. I/C No. :9000903-10-6019

4. Age :13

5.Date of birth :03 September 19906.Address :21 Jalan Besar,Klang,Selangor

7. Parent’s Name :Mohammad Bin Basri

8. Telephone No. :03-332722159

Section B : Co-curricular Activities

Other society / club joined;

* Society :Bahasa Melayu

*Club :Hand Ball *_______________________________________________________________________

I hereby that particulars given above are true and I will abide by the Scouts rules if I am accepted to be a member.

Signature:………………………………………………………………….

Date:……………………………………………………………………….. SCOUTS MOVEMENT, SEKOLAH MENENGAH KEBANGSAAN DATUK HAJI AHMAD SAID, 13800 BUTTERWORTH, PULAU PINANG. _____________________________________________________________________

Scouts Movement Membership Form Section A: Personal Details

1. Name :

2. Form :

3. I/C No. :

4. Age :

5.Date of birth :6.Address :

7. Parent’s Name :

8. Telephone No. :

Section B : Co-curricular Activities

Other society / club joined;

* Society :

*Club : *_______________________________________________________________________

I hereby that particulars given above are true and I will abide by the Scouts rules if I am accepted to be a member.

Signature:………………………………………………………………….

Date:……………………………………………………………………….. SCOUTS MOVEMENT, SEKOLAH MENENGAH KEBANGSAAN DATUK HAJI AHMAD SAID, 13800 BUTTERWORTH, PULAU PINANG. _____________________________________________________________________

Scouts Movement Membership Form Section A: Personal Details

1. Name :

2. Form :

3. I/C No. :

4. Age :

5.Date of birth :6.Address :

7. Parent’s Name :

8. Telephone No. :

Section B : Co-curricular Activities

Other society / club joined;

* Society :

*Club : *_______________________________________________________________________

I hereby that particulars given above are true and I will abide by the Scouts rules if I am accepted to be a member.

Signature:………………………………………………………………….

Date:………………………………………………………………………..