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PSMB/RPL/1/13 (P1) Mycoid Employer Code: (If Applicable

This document is an application for financial assistance under the Pembangunan Sumber Manusia Berhad Act 2001 for a Recognition of Prior Learning scheme. It provides information such as the employer code, registered company name and address, candidate names and details including name, IC number, gender, level/code of program and designation. It also specifies the fees requested, which is the certification fee multiplied by the number of trainees. The applicant declares that the information provided is true and correct.

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Aziz Jamaludin
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35 views

PSMB/RPL/1/13 (P1) Mycoid Employer Code: (If Applicable

This document is an application for financial assistance under the Pembangunan Sumber Manusia Berhad Act 2001 for a Recognition of Prior Learning scheme. It provides information such as the employer code, registered company name and address, candidate names and details including name, IC number, gender, level/code of program and designation. It also specifies the fees requested, which is the certification fee multiplied by the number of trainees. The applicant declares that the information provided is true and correct.

Uploaded by

Aziz Jamaludin
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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PSMB/RPL/1/13(P1)

MYCOID

EMPLOYER CODE

APPLICATION FOR FINANCIAL ASSISTANCE


UNDER PEMBANGUNAN SUMBER MANUSIA BERHAD ACT,2001 (ACT 612)
RECOGNITION OF PRIOR LEARNING SCHEME
Only one copy of this form is required for each programme or level. All parts of this form must be duly completed.
All information given will be held in the strictest confidence.
GENERAL INFORMATION
Types of Application [Please tick ( ) in the appropriate box]
New Application

Training Grant Claim (Please enclose receipt payment from DSD)


Training Grant Claim(International Body)
(Please enclose receipt and RPL Certificate/Approval Letter)

1.

Registered Name Of Company and Address:-

Contact Person : _______________


Telephone No. : _______________
Fax No. : _______________________
Email

: _______________________

Website : _______________________

2.

Name of Recognition Body:

3.

Information Of Candidate:
NAME

NIRC/MYKAD

GENDER

LEVEL/CODE PROG.

UNIT

DESIGNATION

(IF APPLICABLE)

(1) _____________

__________________

________

___________________

____

____________

(2) _____________

__________________

________

___________________

____

____________

(3) _____________

__________________

________

___________________

____

____________

(PLEASE ATTACH LIST OF CANDIDATE)


4.

Fees Requested:
Certification fee
(RM________________ x Number of Trainee ________________ =

Total RM ____________________

5. I/We declare that the facts stated in this application and the accompanying information are true and
correct and that I/We have not withheld/distorted any material facts. I/We understand that if I/We obtain
the grant by false or misleading statements, I/We may be prosecuted under Section 41 of Pembangunan
Sumber Manusia Berhad Act 2001 (Act 612) and in addition, PSMB may, at its discretion, withdraw the grant
and recover immediately from us any amount of the grant that may have been disbursed.
SIGNATURE

:__________________________

NAME

:__________________________
(Chairman/ManagingDirector/General Manager/
HR Manager)+

STAMP OF DESIGNATION:_________________________
DATE

:
+Delete where inapplicable/* If applicable

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