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unisel
UNIVERSITI SELANGOR
Perjanjian Biasiswa Asas UNISEL 1220/020827080108
PADA MENYAKSIKAN HAL DI ATAS pihak-pihak yang tersebut dalam Perjanjian ini telah
BAHAGIAN UNISEL DIBIARKAN KOSONG
menurunkan di sini tandatangan-tandatangan dan meteri-meteri mereka pada haribulan dan tahun
yang mula tertulis di atas.
DIT ANDATANGANI OLEH UNIVERSITI SELANGOR
Ditandatangan oleh
------------------···································································----
(Tandatangan Pegawai Yang Diberi Kuasa)
Nama
------------------····························································-----
(Nama Penuh Pegawai dengan Huruf Besar seperti di Kad Pengenalan)
No. Kad Pengenalan
Cop Jawatan & Jabatan
DI HADAPAN:
Tandatangan Saksi ---------------------········································-----
Nama Saksi ------------------····························································-----
No. KIP Saksi ---------------------········································-----
DIT ANDATANGANI OLEH PELAJAR
Ditandatangan oleh
---------------------········································-----
(Tandatangan Pelajar)
Nama AHMAD BIN ALI
---------------------········································-----
(Nama Penuh Pelajar dengan Huruf Besar seperti di Kad Pengenalan)
No. Kad Pengenalan 00000000000
------------------····························································-----
DI HADAPAN:
Tandatangan Saksi ---------------- - - ---········································-----
_____________________ ........................................ _____
Nama Saksi
No. KIP Saksi ------------------····························································-----
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