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Username Penaja Tarikh Masuk Data Username Pemohon Jumlah Bantuan Dipohon A. MAKLUMAT PEMOHON

BORANG PERMOHONAN. BANTUAN KEUSAHAWANAN . Konsortium Alumni UiTM Berhad . . KAUB. SGSB. Saza Gemilang SDN.BHD. Username Penaja Tarikh Masuk Data Username Pemohon Jumlah Bantuan Dipohon A. MAKLUMAT PEMOHON Nama Penuh Pemohon ( seperti di dalam kad pengenalan )

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Username Penaja Tarikh Masuk Data Username Pemohon Jumlah Bantuan Dipohon A. MAKLUMAT PEMOHON

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  1. BORANG PERMOHONAN BANTUAN KEUSAHAWANAN Konsortium Alumni UiTMBerhad. KAUB SGSB • SazaGemilang SDN.BHD Username PenajaTarikhMasuk Data Username PemohonJumlahBantuanDipohon A. MAKLUMAT PEMOHON NamaPenuhPemohon (seperti di dalamkadpengenalan) 2. No. KadPengenalanBaru (KPT) 3. Agama 4. Nama IbubapaUntukRujukan 5. AlamatRumah Poskod No Telefon HP KEGUNAAN PEJABAT TarikhTerimaBorang : …………………………………………… Gambar KadPengenalan Pengesahan Permohonan :- LULUS / TIDAK LULUS ….............................................. Tandatangan & nama Tarikh : TarikhBorangPersetujuanditerima :- Boranglengkap / Tidak Lengkap YuranPendaftaran & Kursus RM550-00. Catatan :- …………………………………………… …………………………………………… …………………………………………… …………………………………………… …………………………………………… ………………………………………..... Tandatangan & Nama Tarikh : RM2,000 / RM4,000 / RM8,000 B. PENGAKUAN PEMOHON - Sayamengakubahawasegalamaklumat yang diberidandikemukakan di dalampermohonaniniadalahbenar. Saya juga fahamdanbersetujudengantermadansyarat yang telahditetapkan di dalampermohonanini. Pemohon :………………………………………………………………… Tandatangan ………………………………………Tarikh……………………… D. PENGESAHAN – SAZA GEMILANG SDN BHD / KONSORTIUM ALUMNI UITM BERHAD Tandatangan:…………………………………… Tarikh………………….. Tandatangan :……………………………………Tarikh…………….… SazaGemilang SDN.BHD. No,42-1,Jalan komersial 7, DataranSenawang 70450 Sermban. N.S Konsortium Alumni UiTMBerhad. No. 22, JalanBawangMerah, 24/36 Seksyen 24. 40300 Shah alam Selangor DarulEhsan. Tel: 03-5548 3048. Pembayaranhendaklahdibuatmelaluichek/mony order /bank drafatasnama: sazagemilangsdnbhd Atau on line Am Bank : 1232022008842 MEMANGKIN EKONOMI UMMAH

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