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Boulder Fence Competition Registration
School Info
School Name(*)
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School Address(*)
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School Phone(*)
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School Fax. No.(*)
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Accompanying Teacher Name(*)
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Accompanying Teacher's IC Number(*)
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Accompanying Teacher's Gender(*)
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School Email / Accompanying Teacher's Email(*)
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Please ensure the email is valid, all information will sent to this email.
Accompanying Teacher's Phone No.(*)
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Accompanying Teacher's Food Preference(*)
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Group Name(*)
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Participants Number(*)
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Information of Participant 1
Participant 1's Name (Leader)(*)
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Participant 1's IC Number(*)
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Participant 1's Gender(*)
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Participant 1's Phone Numbers(*)
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Participant 1's Email(*)
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Participant 1's Address(*)
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Participant 1's Emergency Contact(*)
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Participant 1's Emergency Contact's Name(*)
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Participant 1's Food Preference(*)
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Information of Participant 2
Participant 2's Name(*)
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Participant 2's IC Number(*)
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Participant 2's Gender(*)
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Participant 2's Phone Numbers(*)
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Participant 2's Email(*)
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Participant 2's Address(*)
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Participant 2's Emergency Contact(*)
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Participant 2's Emergency Contact's Name(*)
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Participant 2's Food Preference(*)
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Information of Participant 3
Participant 3's Name(*)
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Participant 3's IC Number(*)
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Participant 3's Gender(*)
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Participant 3's Phone Numbers(*)
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Participant 3's Email(*)
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Participant 3's Address(*)
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Participant 3's Emergency Contact(*)
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Participant 3's Emergency Contact's Name(*)
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Participant 3's Food Preference(*)
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Information of Participant 4
Participant 4's Name(*)
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Participant 4's IC Number(*)
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Participant 4's Gender(*)
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Participant 4's Phone Numbers(*)
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Participant 4's Email(*)
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Participant 4's Address(*)
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Participant 4's Emergency Contact(*)
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Participant 4's Emergency Contact's Name(*)
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Participant 4's Food Preference(*)
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Information of Participant 5
Participant 5's Name(*)
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Participant 5's IC Number(*)
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Participant 5's Gender(*)
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Participant 5's Phone Numbers(*)
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Participant 5's Email(*)
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Participant 5's Address(*)
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Participant 5's Emergency Contact(*)
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Participant 5's Emergency Contact's Name(*)
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Participant 5's Food Preference(*)
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Kindly make payment to us as banking details below, and obtain the proof-of-payment before continue to submit this form.

RM 40.00 per Team

Bank name: AMBANK

Bank Address: MENARA LIANG COURT, NO. 37, JALAN SULTAN AHMAD SHAH, 10050 PENANG, PULAU PINANG

Bank Account Number: 002-201-101022-6

Account Name: The Institution of Engineers, Malaysia

Upload Proof of Payment(*)
Maximum File Size 4MB, please reduce you file
Kindly upload your proof of payment here (Photo / Scanned PDF). Maximum file size 4MB.
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The Institution of Engineers, Malaysia (Penang Branch)
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Email : admin(a)iempenang.org / iempenangbranch(a)gmail.com

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