KELAB/PERSATUAN : ____________________
TARIKH : ____________________ MASA :__________________
Bil Nama Murid Kelas Alasan
10
_________________________________
( )
4
5
10
_________________________________
( )
KELAB/PERSATUAN : _______________________________________
TARIKH : _______________________________________
ALASAN : _______________________________________
_______________________________________
DIJALANKAN _______________________________________
________________________________ ____________________________
( ) ( TENG KIM UNG )
Guru Besar
SJK(C) Kwang Chien
Sarikei