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ONLINE CePSWaM REGISTRATION FORM 2020
1 Form For 1 Participant ONLY. For group registration kindly email
greenvellmsb@gmail.com
. Any inquiry please call Hotline 011-39250036
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PART A : PARTICIPANT DETAILS INFORMATION
Course Date & Location
*
Choose
05 Jan - 09 Jan 2020 : Hotel @ Johor Bahru
20 Jan - 24 Jan 2020 : Hotel Bangi-Putrajaya, Bangi
10 Feb - 14 Feb 2020 : Hotel De Palma Shah Alam
24 Feb - 28 Feb 2020 : Hotel @ Petaling Jaya
02 Mar - 06 Mar 2020 : Hotel The Light, Seberang Jaya
08 Mar - 12 Mar 2020 : Hotel @ Johor Bahru
16 Mar - 20 Mar 2020 : Hotel Bangi-Putrajaya, Bangi
30 Mar - 03 Apr 2020 : Hotel @ Melaka
06 Apr -10 Apr 2020 : Hotel De Palma Shah Alam
13 Apr - 17 Apr 2020 : Kuching, Sarawak
Full Name (as per IC/MyKad)
*
Will appear in Certificates
Your answer
Ic No/MyKad
*
Will appear in Certificates (Ex : 780106-14-5034)
Your answer
Age
*
Your answer
Sex
*
Choose
Female
Male
Bumiputera Status
*
Choose
Yes
No
Highest Academic Qualification (Please Send A Certified True Copy of Your Certificates via Email to
greenvellmsb@gmail.com
for Verification)
*
Master/PhD
Degree
Diploma
Polytechnic Certificate/SKM Level 3
SPM with 3 years’ experience handling scheduled waste. (Please attach a letter from the company to confirm the working experience in handling schedule waste)
Other:
Field of Study
*
Engineering
Science
Other:
Valid Email Address
*
Course Confirmation will be send to this email address
Your answer
Valid Handphone No
*
Your answer
Mailing Address (Resident)
*
Your answer
Current Job Position
*
Your answer
Working Experiences
*
Your answer
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