Phg. P.U.12/1995
PEGUAM SYARIE REGULATIONS 1995
FORM A
(Regulation 10)
APPLICATION FOR ADMISSION AS A PEGUAM SYARIE
To:
The Chairman of the Peguam Syarie Committee.
With due respect I apply to be admitted as a Peguam Syarie and hereunder are my personel particulars.
(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. Identification Card Number:
10. Place and Date of Issue:
11. Regular Business Address:
12. Telephone Number:
13. Address of Residence:
14. Sect:
15. Qualification:
16. Experience:
I hereby affirm that all particulars stated above are true.
Date .......................................... ..........................................
Signature of Applicant
REMINDER
The Applicant shall submit certified true copies of certificates, testimonials, recommendations and other relevant documents to support his application.
FOR COMMITTEE'S ONLY
FOR COMMITTEE'S USE ONLY
Date of receipt:
Decision of the Committee: Approved/Rejected/Postponed
Reasons for postponement:
Date when Applicant Informed:
Date of Receipt of Registration Fee:
Receipt Number:
Sent on:
Entered into The Register:
Serial Number:
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