PART I: APPLICANT'S COMPANY INFORMATION

Company Name:

Company Address:

Company Address:

Email Address:

Contact Person:

Contact No:

Fax No.

Mobile No.

PART II: COURSE REGISTRATION INFORMATION

*PLEASE TICK IN RESPECTIVE AREA

Course Applied:

BOOM LIFT OPERATION COURSE (BLOC - ENGLISH) DURATION 8 HOURS FROM 8:00-17:00

SCISSOR LIFT OPERATION COURSE (SLOC - ENGLISH) DURATION 8 HOURS FROM 8:00-17:000

BOOM LIFT OPERATION COURSE (BLOC - CHINESE) DURATION 8 HOURS FROM 8:00-17:00

SCISSOR LIFT OPERATION COURSE (SLOC - CHINESE) DURATION 8 HOURS FROM 8:00-17:00

OTHER COURSE

PART III: APPLICANT'S PARTICULARS
S/N
1
2
3
4
5
Name as in passport
NIRC/FIN No.
Nationality
Age
Contact No.

TOTAL COURSE FEE:

PAYMENT MADE BY: CASH CHEQUE NO :