8/16/2019 borang_penerbit_baru
1/1
PNM.PK(O)PBN.02(B1)
.
3
BORANG PENDAFT ARAN PROGRAM ISBN /ISBN PROGRAMME REGISTRAT ION FORM
LENGKAPKAN SEMUA BUTIRAN. PERMOHONAN TIDAK LENGKAP TIDAK AKAN DIPROSES
A. MAKLUMAT PENERBIT / PUBLISHER INFORMATION
Penerbit / Publisher : ........................................................
Alamat/Address .........................................................
.........................................................
.........................................................
Telefon / Telephone: ......................................................... Faks / Fax : ...............................
E-mail : .........................................................
B. SOAL SELIDIK PENERBITAN / QUESTIONNAIRE ON PUBLISHING
1. Sila nyatakan bilangan judul yang telah diterbitkan tanpa ISBN
Total of title have been published without ISBN:.....................................................................
2. Tarikh mula penerbitan
Publishing starting date :..............................................................................................................................
3. Bilangan judul yang dicadangkan diterbitkan dalam tempoh 10 tahun10 years expectation number of titles will be published : ............................................................................
4. Bilangan judul dalam proses cetakan Number of title in printing process : ...........................................................................................................
C. AKUAN / ACKNOWLEDGEMENT
Nama Pemohon / Applicant name:....................................................................................................................
Jawatan / Designation: ......................................................................................................................................(Pengerusi/Pengurus/Setiausaha/Pengarah/Pemilik)
Tarikh Permohonan / Date Apply: ...................................................................................................................
..............................................................................Tandatangan & Cop Rasmi Syarikat
Signature & Official Company Rubber Stamp
Nota / Note: Sila sertakan salinan Perakuan Pendaftaran syarikat (Borang D) dan lampiran nama pemilik dansalinan kad pengenalan bagi penerbit individu / Please attach with the copy of ROC certificatedan r copy of identity
card for individual publisher.
PUSAT KEBANGSAAN ISBN / ISSN
Aras 3, Anjung Bestari, PERPUSTAKAAN NEGARA MALAYSIA232, Jalan Tun Razak, 50572 Kuala Lumpur
TEL: 03-26814329, 03-26871700 samb 4288 ; FAX : 03-26811676Email: isbn @pnm.gov.my