Go back to See form:
| 1a. Applicant' name .................................: |
Peter Lai |
| 1b. requested Email address (1st choice): |
peterlai@ace.cdc.abu.com |
| 1c. requested Email address (2nd choice): |
laipeter@ace.cdc.abu.com |
| 1d. Street address.....................................: |
No. 123456, Rubber Road west,Kuching, Sarawak, Malaysia |
| 1da. Street address...................................: |
No. 51111c, Singapore ( eg only ) |
| 1e. City......................................................: |
Kuching for ( 1d. ) Singapore ( 1da ) |
| 1f. State.....................................................: |
Sarawak for (1d. ) Singapore for ( 1da ) |
| 1g. Country code ( e.g. us, uk,) ...............: |
Sarawak, Malaysia ( 1f ) Singapore ( 1da ) |
| 1h. Category : |
|
| |
2 |
3=Organisation 4=Personal :
|
4 |
| 1i. Date of application.(yyyy.mm.dd)......: |
1996.09. 20 |
FOR students only |
|
| 2a. Date of Birth..(yyyy.mm.dd)..........: |
1980 - 12 -25 |
| 2b. School..............................................: |
St. Joseph, Kuching, Sarawak. |
Proposer's information |
|
| 3a. Proposer's name..............................: |
John Try XXX |
| 3b. Proposer's email address................: |
john@pl.jaring.my |
Seconders' Information. |
|
| 4a. 1st. Seconder's name.......................: |
Albert Test XXX |
| 4b. 1st. Seconder's email address ........: |
albert@ace.cdc.abu.com |
| 5a. 2nd. Seconder's name......................: |
Jacob Liew |
| 5b. 2nd. Seconder's email address........: |
jacob@kuching.cdc.com.my |