Module PBS Form 2 | SMK Tengku Afzan, Kuantan

Name:........................................................................
Date:..........................
Band
Performance
Standard
Descriptor
Evidence

Class:.........................

1 (WRITING)
B1
Know fundamental skills in listening, speaking, reading and
writing
B1 DT2
Understanding the requirements of application forms
B1 DT2 E1
Able to complete an application form

Instrument
Your school is organizing an annual general meeting for club and society. You are to
fill in the membership form to join the English Language Society.
CLUB/ SOCIETY APPLICATION FORM
CLUB/SOCIETY : ______________________________________________________
PERSONAL INFORMATION

Name (as in NRIC or passport): ______________________________________________

(Please underline surname)
I/C Number: _____________________________________________________________
Date of Birth: ___________________________ Place of Birth: ____________________
Address: ________________________________________________________________
_____________________ Postal Code: _________________ State: ________________
Contact No : __________________ Email address: _______________________________
Interest(s) :
______________________________________________________________________________________
________________________________________________________
REASON(S) FOR APPLYING FOR THE CLUB/ SOCIETY
______________________________________________________________________________________
________________________________________________________
I verify that the above information is correct to the best of my knowledge.
I accept that providing false information deliberately could result in my dismissal.

Signature: ______________________
Assessment:
ACHIEVED
NOT ACHIEVED

Date: __________________________

Module PBS Form 2 | SMK Tengku Afzan, Kuantan