SOUTHERN INTERNATIONAL SCOUT FIESTA

22nd JULY 2017

SMK DATO PENGGAWA BARAT,
JALAN PARIT MASJID,
82000 PONTIAN, JOHOR, MALAYSIA
CONTINGENT REPLY SLIP

National Scout Organisation (NSO) SMK BANDAR PUTRA KULAI

JOHOR/KULAI/058
State / District / Group

CONTINGENT REPLY SLIP (LEADERS)

Full Name Gender Age Scouting Position Contact Number / Personal Email
1 MOHD ANWAR ALWI M 28 ADC 0134501950
2 GAN GUAN CHIN M 40 PENOLONG PEMIMPIN
3 AINI MARIA F 30 PENOLONG PEMIMPIN
4 NURIN F 17 PR
5 NADIA NATASHA F 17 PR
6 NADRAH SYUHADA F 17 PR
7 NURUL SYIFAA F 17 PR
8 CHAI CHEE NING F 17 PR
9 TEA YI TIAN F 17 PR
10 LAURA F 17 PR
11 UMMI HAMIZAH F 17 PR
 Full Name Gender Age Scouting Position Contact Number / Personal Email
12 JIVA RAJ A/L MOYAN M 17 PR
13 ROOHAN A/L PANNER SELVAM M 17 PR
14 THANESSWAREN A/L JAYAKUMAR M 17 PR
15 AMINUR FIKRI M 16 PR
16 DANISH HAKIM AZHAR M 17 PR
17 ABDUL THAQIF M 17 PR
18 AMMAR M 17 PR
19 NUR DINI IZAZI BIN SHAFII M 17 PR
20 MUHAMMAD AZRI ASYRAF BIN ABU SEMAN M 16 PR
21 NICOLE LEONG F 16 PR
22 AINA HUMAIRA BT ALIAS F 16 PR
23 NURIN IZZWANI BT MD AZMI F 16 PR
24 AHMAD ZUFAR BIN AZRUL M 16 PR
25 DANIAL HAKIM BIN MD HANAFIAH M 16 PR
26 NUR SABRINA BT GHAZALI F 16 PR
27 KENNARD RAMBA LIM TJIN HAO M 13 PM
28 AJJET A,L VEJAYAN M 13 PM
29 PRAVEER SACHI RAJ A/L THANARAJ M 13 PM
NURIFFAHTUL IZZATY NAZURAH BT MOHD
30 F 13 PM
FIRDAUS
31 NUR SHELA ELYZA BT AMMERIZA F 13 PM
32 KURT JONATHAN A/L ARIKASAMY F 13 PM
 SHOUN SANTHANA DAS A/L RAYMON
33 M 13 PM
SANTHANA DAS
34 AMIRUL HAFIZ BIN MD NIZAM M 14 PM
35 LIEW XUN HAN M 13 PM
36 AHMAD AKMAL AZIZI BIN AHMAD AFENDI M 14 PM
37 IRFAN IRSYAD BIN ZAINAL ABIDIN M 13 PM
38 IZZ ZAYANI BT ABDUL HALIM F 13 PM
39 TAY SIAN LE F 13 PM
40 GAN KAI XIN F 13 PM
41 J. HIRTHIROSHINI NAIR A/P JEYAKUMAR F 13 PM
42 NURAFIQAH BT MOHD FUAD F 13 PM
43 ANGELINA MAISARAH BT ANTHONY F PM
44 NURIN INSYIRAH BT MOHD AZMI F 13 PM
45 MOHD AIZZAT DANISH BIN ABD HALIM M 13 PM
46 LIEW YUE HAN M 14 PM
47 CHE NOR SAFIUDDIN BIN CHE MOHD SAFRI F 13 PM
48 MUHAMMAD AIMAN HAKIM BIN SAHRUL MIZAL M 13 PM
49 MUHAMMAD HARITH BIN BORHAN M 13 PM
50 FAIZ HAKIMI BIN MAT ZALAN M 14 PM
Prepared by: ..............................................
Contingent Secretary
Summary of Contingent Registration:
Name: Leaders Participants
Scouting Position:
Total 3 47

Certified by:............................................. Payment (RM) RM 30.00 x 3 RM 30.00 x 47

Contingent Leader
Name: = RM 90.00 = RM 1410
Scouting Position:
Total Payment (RM) RM 1500

Approved by:..............................................
Chief Commissioner / International Commissioner /
State / District Commissioner Note:
Name:
1. For early registration, please send the Contingent Reply Slip by 5 July 2017 to 2017sisf@gmail.com
2. Early registration is needed for the secretariat to prepare the festival kits.
3. For walk-in registration, please bring the Contingent Reply Slip on the day of the event.
Received by:.............................................. 4. All payment and sales will be in Malaysian Ringgit (RM).
Director / Secretary 5. All cash payments and cheque can be made payable to YAYASAN PENDIDIKAN DAN KEBAJIKAN SMKDPB
Southern International Scout Fiesta 2017 (CIMB: 800 588 0302)

* Please use additional sheets if there is not enough space.