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Entry Form: Section A - Escorting Advisor Information

This document is an entry form for an international festival of innovation on green technology and invention. It requests information from participants including advisor and participant details, invention/innovation details, and an affirmation of following the regulations. Participants must submit the completed form by March 10, 2019 for consideration to present their innovation in categories such as computer, graphic, prototype, or chemical reaction displays.

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Vanitha Nitha
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34 views3 pages

Entry Form: Section A - Escorting Advisor Information

This document is an entry form for an international festival of innovation on green technology and invention. It requests information from participants including advisor and participant details, invention/innovation details, and an affirmation of following the regulations. Participants must submit the completed form by March 10, 2019 for consideration to present their innovation in categories such as computer, graphic, prototype, or chemical reaction displays.

Uploaded by

Vanitha Nitha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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INTERNATIONAL FESTIVAL OF INNOVATION ON GREEN TECHNOLOGY &INNOVATION, INVENTION, DESIGN, EXPOSITION 2019

Application Instruction:
This form is to be returned not later by 10th March 2019
FOR SECRETARIATS REFERENCE ONLY
at [email protected]
Date of reception :
ENTRY FORM Recipient :
SECTION A – ESCORTING ADVISOR INFORMATION

NAME: ________________________________________________________________________________

IC NO. GENDER: ______________________________________________________ MALE FEMALE

PASSPORT NO.: _________________________________________________

OFFICE NO.: __________________________________________________________

HP NO.: _______________________________________________________________

SECTION B – PARTICIPANT INFORMATION

INSTITUTION NAME: ___________________________________________________________________

LEVEL OF EDUCATION: ELEMENTARY SCHOOL SECONDARY SCHOOL

UNIVERSITI/COLLEGE

1. NAME OF APPLICANT (team leader):


_______________________________________________________________________________________

IC NO. GENDER: _________________________________________________________ MALE FEMALE

PASSPORT NO.*: _________________________________________________________

EMAIL: __________________________________________________________________

HP NO.: __________________________________________________________________

2. NAME OF APPLICANT (member):


_______________________________________________________________________________________

IC NO. GENDER: _________________________________________________________ MALE FEMALE

PASSPORT NO.*: _________________________________________________________

EMAIL: __________________________________________________________________

HP NO.: __________________________________________________________________

3. NAME OF APPLICANT (member):


_______________________________________________________________________________________

IC NO. GENDER: _________________________________________________________ MALE FEMALE

PASSPORT NO.*: _________________________________________________________

EMAIL: __________________________________________________________________

HP NO.: __________________________________________________________________
INTERNATIONAL FESTIVAL OF INNOVATION ON GREEN TECHNOLOGY &INNOVATION, INVENTION, DESIGN, EXPOSITION 2019

SECTION C – INVENTION/INNOVATION INFORMATION

3. TITLE OF INVENTION/INNOVATION:

_______________________________________________________________________________

4. NAME OF INDIVIDUAL(S) INCLUDING PROJET LEADER THAT YOU WISH TO APPEAR ON


AN AWARD CERTIFICATE (IF AN AWARD IS WIN):

_________________________________________________________________________________________________

______________________________________________________________________________________________

5. INVENTION/INNOVATION CATEGORY (Refer on finog.ump.edu.my):

______________________________________________________________________________________________

6. METHOD OF DISPLAY: COMPUTER GRAPHIC/PLAN PHOTOGRAPH

COMBUSTION (Using fire) CHEMICAL REACTION

PROTOTYPE MODEL OTHER:

7. INVENTION/INNOVATION ABSTRACT:

______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________

8. OTHERS:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
INTERNATIONAL FESTIVAL OF INNOVATION ON GREEN TECHNOLOGY &INNOVATION, INVENTION, DESIGN, EXPOSITION 2019

SECTION D – AFFIRMATION

I, IC No./Passport No. , hereby


(Name of team leader)
represent my team to clarify that we have read the regulations that provided by the organizing, committee and will follow
all the outlined regulations.

I, represent my team to clarify that all the information given are


(Name of team leader)
true and factual.

CLARIFICATION:

…………………………………
(Team Leader Signature)

‘’’’

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