WORKING AT HEIGHT (WAH)

Date Course (Tarikh Kursus) *

Participant Name (Nama Peserta) *

IC Number (No. Kad Pengenalan) *

Email *

Home Address (Alamat Rumah) *

Poscode (Poskod) *

State (Negeri) *

Home Tel. Number (No. Tel. Rumah)

Handphone Number (No. Tel. Bimbit) *

Physical Health Condition (Tahap Kesihatan Fizikal)

Source of Information about Course (Sumber mendapat maklumat mengenai kursus) *

Acquaintance (Kenalan)

Facebook

Website (Laman Web)

Media (Media Cetak)

Note of Disclaimer : All the abovecaptioned shall be subject to all terms and conditions as setforth by HRSB Training Sdn. Bhd. and this shall include but not limited to any change of date/time/venue as deems necessary by the training organizer of HRSB Training Sdn. Bhd.