Schedule - FORM A (PEGUAM SYARIE RULES 2000

Kn. P.U. 10/2000
PEGUAM SYARIE RULES 2000

Schedule - FORM A

(Rule 10)

APPLICATION FORM FOR ADMISSION AS A PEGUAM SYARIE

To,
The Chief Syariah Judge,
State of Kelantan.

I have the honour to apply to be admitted as a Peguam Syarie and my personal particulars are as follows:

(To be filled by the Applicant in CAPITAL LETTERS).

1. Name:

2. Other Names (if" any):

3. Sex:

4. Date of Birth:

5. Place of Birth:

6. Single/Married:

7. Citizenship:

8. Race:

9. Identity Card Number and Colour:

10. Place and Date of Issue of Identity Card:

11. Regular Business Address:

12. Telephone Number:

13. Address of Residence:

14. Sect:

15. Qualification:

16. Experience:

I hereby affirm that all the particulars stated above are true.

Date: .....................................

................................................
Signature of Applicant

REMINDER:

The Applicant shall submit certified true copies of certificates, testimonial, recommendations and other relevant documents to support his application.

FOR OFFICE USE ONLY

Date of Receipt:

Decision of the Chief Syariah Judge:

Approved:

Postponed:

Reasons for Postponement:

Date When Applicant Informed:

Date of Receipt of Registration Fee:

Receipt Number:

Sent on:

Entered into the Register:

Serial Number: