PERSONAL PARTICULARS

Name:______________________________________________________________________________

Address:____________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

City:______________________ Country:__________________________ Zip:_____________________

Age:______ Sex:________ Date of Birth:_______________ Place of Birth:_________________________

Occupation:____________________________________________________________________________

Telephone No.:___________________ Fax: ________________ E-mail: __________________________

SAHIB'S AL-ISLAM TUTORIAL SCHOOL- ROBINSON ROAD P. O. BOX 3888, SINGAPORE 905888. TEL.:0065-5650763 & FAX: 0065-5650991

EDUCATIONAL PARTICULARS

Highest Qualification Attained:__________________ Year of Passing examination: ____________

Institution:_______________________________________ Country: _____________________

CERTIFICATE COURSES / DIPLOMA COURSES

Please tick ( / ) at the appropriate Course / Diploma box

PAYMENT

I attach hereto a Money Order / Postal Order / Bank Draft / Cheque* for the amount of Singapore Dollars or its equivalent in US$______________ being the payment for the course(s) selected together with a non-refundable registration fee of S$50/= only.

*Please delete whichever is inapplicable

DECLARATION

I agree that the course(s) I have enrolled for are for my own personal study, and I understand that the course materials are copyright and cannot be reproduced by any method or in any form without the written permission from the Management Board of the School. All text books remain my property. I have read the Conditions of Enrollment and I agree to abide by them.

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Signature of Student