PNM.PK(O)PBN.

02(B1)
.

PUSAT KEBANGSAAN ISBN / ISSN

Aras 3, Anjung Bestari, PERPUSTAKAAN NEGARA MALAYSIA
232, Jalan Tun Razak, 50572 Kuala Lumpur
TEL: 03-26814329, 03-26871700 samb 4288 ; FAX : 03-26811676
Email: isbn @pnm.gov.my

BORANG PENDAFTARAN PROGRAM ISBN /

ISBN PROGRAMME REGISTRATION FORM
LENGKAPKAN SEMUA BUTIRAN. PERMOHONAN TIDAK LENGKAP TIDAK AKAN DIPROSES

A. MAKLUMAT PENERBIT / PUBLISHER INFORMATION

Penerbit / Publisher :

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Alamat/Address

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.........................................................
.........................................................

Telefon / Telephone:

.........................................................

E-mail :

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Faks / Fax : ...............................

B. SOAL SELIDIK PENERBITAN / QUESTIONNAIRE ON PUBLISHING

1.

Sila nyatakan bilangan judul yang telah diterbitkan tanpa ISBN

Total of title have been published without ISBN:.....................................................................

2.

Tarikh mula penerbitan

Publishing starting date :..............................................................................................................................

3.

Bilangan judul yang dicadangkan diterbitkan dalam tempoh 10 tahun

10 years expectation number of titles will be published : ............................................................................

4.

Bilangan judul dalam proses cetakan

Number of title in printing process : ...........................................................................................................

C. AKUAN / ACKNOWLEDGEMENT
Nama Pemohon / Applicant name:....................................................................................................................
Jawatan / Designation: ......................................................................................................................................
(Pengerusi/Pengurus/Setiausaha/Pengarah/Pemilik)
Tarikh Permohonan / Date Apply: ...................................................................................................................

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Tandatangan & Cop Rasmi Syarikat
Signature & Official Company Rubber Stamp
Nota / Note: Sila sertakan salinan Perakuan Pendaftaran syarikat (Borang D) dan lampiran nama pemilik dan
salinan kad pengenalan bagi penerbit individu / Please attach with the copy of ROC certificatedan r copy of identity
card for individual publisher.