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91B, Jalan Kenari 20, Bandar Puchong Jaya, 47100 Puchong, Selangor, Malaysia.
T/F : 03-5879 7831 E : [email protected] W : www.masmo.info
MASMO SCIENCE 2013 WORKSHOP REGISTRATION FORM
Please complete with BLOCK letters only. Deadline for submission: 31st May, 2013 (Friday)
Parent / Guardian DETAILS Name
Address
Postcode State
Contact Number Email
PARTICIPANTS DETAILS
Name
SCHOOL NAME
YEAR 4 / 5 / 6 / 7 / 8 / 9 Contact Number
BIRTH YEAR DD / MM / YYYY *GENDER
Date of Birth: Y = Year; *Please circle
MASMO Science WorkshopSession Date Class
2/6/2013Class 1Class 2
3/6/2013Class 3Class 4
4/6/2013 Class 54/6/2013 Class 6
5/6/2013Class 7Class 8
6/6/2013Class 9
Class 10
Training Fee for 1 class RM80
No. of Independent Class : ________class(es)No. of Session : ________session(s)Inventor Kit : ________kit(s)
REGISTRATION PAYMENT
please write the School Name, Contact Number.)
[email protected] with School Name, and Contact Number.
MASMO Science Workshop (IKEN SCIENTIFICA)
Session 1
Session 2
Location ：91B, Jalan Kenari 20, Bandar Puchong Jaya, Puchong, Selangor.Training Fee ：Inventor Kits RM500 ( Optional )
Training Fee for 1 Session RM300（5 Classes）
CASH or CHEQUE (Please make cheque payable to Olympic Edu Sdn Bhd. On the reverse of each cheque,
Fax/Email - Please bank in the cash/cheque payment to Olympic Edu Sdn Bhd (Public Bank 3146-5613-25),
(Maybank 5123-4355-4047) then fax / email the bank-in slip to: 03-5879 7831 /
For any queries, please contact us at 03-5879 7831 or email to [email protected]. Thanks.
91B, Jalan Kenari 20, Bandar Puchong Jaya, 47100 Puchong, Selangor, Malaysia.
T/F : 03-5879 7831 E : [email protected] W : www.masmo.info
MASMO SCIENCE 2013 WORKSHOP REGISTRATION FORM
Please complete with BLOCK letters only. Deadline for submission: 31st May, 2013 (Friday)
MALE / FEMALE
Time0900-12301400-17300900-12301400-17300900-12301400-17300900-12301400-17300900-12301400-1730
[email protected] with School Name, and Contact Number.
MASMO Science Workshop (IKEN SCIENTIFICA)
. On the reverse of each cheque,
to Olympic Edu Sdn Bhd (Public Bank 3146-5613-25),
(Maybank 5123-4355-4047) then fax / email the bank-in slip to: 03-5879 7831 /
@masmo.info. Thanks.
