DSA - Deferment Forms / Borang Penangguhan Kelas
Number of Student /Jumlah Pelajar:
*
Please Select / Sila Pilih
1
2
3
Student Details / Maklumat Pelajar
Swim Centre / Cawangan:
*
Please Select / Sila Pilih
DSA Bukit Jalil
DSA Setapak
DSA Kampung Pandan
DSA Shah Alam
DSA Seberang Jaya
DSA Bandar Dato' Onn
DSA Bandar Utama
DSA Bukit Kiara
DSA Setia Alam
DSA Bandar Rimbayu
Student Full Name / Nama Penuh Pelajar:
*
as per MyKad / Passport / Legal Documents | seperti yang tertera dalam MyKad / Pasport / Dokumen Sah
Student ID / ID Pelajar:
Swim Program / Program:
*
Please Select / Sila Pilih
Baby & Me Program
Kiddie Swimmers Program
Junior Swimmers Program
Mini Squad Program
Young Swimmers Program
Adult Swimmers Program
Private Swimming Program
Water Polo Program
Synchronized Program
DLMY x DSA Diving Program
Lesson Day / Hari Kelas:
*
Please Select / Sila Pilih
Saturday / Sabtu
Sunday / Ahad
Monday / Isnin
Tuesday / Selasa
Wednesday / Rabu
Thursday / Khamis
Friday / Jumaat
Lesson Time / Masa Kelas
AM
PM
AM/PM Option
2nd Student Full Name / Nama Penuh Pelajar Kedua:
*
as per MyKad / Passport / Legal Documents | seperti yang tertera dalam MyKad / Pasport / Dokumen Sah
2nd Student ID / ID Pelajar Kedua:
2nd Student Swim Program / Program Pelajar Kedua:
*
Please Select / Sila Pilih
Baby & Me Program
Kiddie Swimmers Program
Junior Swimmers Program
Mini Squad Program
Young Swimmers Program
Adult Swimmers Program
Private Swimming Program
Water Polo Program
Synchronized Program
DLMY x DSA Diving Program
2nd Student Lesson Day / Hari Kelas Pelajar Kedua:
*
Please Select / Sila Pilih
Saturday / Sabtu
Sunday / Ahad
Monday / Isnin
Tuesday / Selasa
Wednesday / Rabu
Thursday / Khamis
Friday / Jumaat
2nd Student Lesson Time / Masa Kelas Pelajar Kedua:
AM
PM
AM/PM Option
3rd Student Full Name / Nama Penuh Pelajar Ketiga:
*
as per MyKad / Passport / Legal Documents | seperti yang tertera dalam MyKad / Pasport / Dokumen Sah
3rd Student ID / ID Pelajar Ketiga:
3rd Student Swim Program / Program Pelajar Ketiga:
*
Please Select / Sila Pilih
Baby & Me Program
Kiddie Swimmers Program
Junior Swimmers Program
Mini Squad Program
Young Swimmers Program
Adult Swimmers Program
Private Swimming Program
Water Polo Program
Synchronized Program
DLMY x DSA Diving Program
3rd Student Lesson Day / Hari Kelas Pelajar Ketiga:
*
Please Select / Sila Pilih
Saturday / Sabtu
Sunday / Ahad
Monday / Isnin
Tuesday / Selasa
Wednesday / Rabu
Thursday / Khamis
Friday / Jumaat
3rd Student Lesson Time / Masa Kelas Pelajar Ketiga
AM
PM
AM/PM Option
Back
Next / Seterusnya
Action Requested / Tindakan Diperlukan
Student Full Name / Nama Penuh Pelajar:
Effective Term / Tempoh Bermula:
*
Please Select / Sila Pilih
Term 1
Term 2
Term 3
Term 4
Term 5
Term 6
Term 7
Term 8
Term 9
Term 10
Term 11
Term 12
Term 13
Term 14
Term 15
Defer Start Date / Tarikh Mula Ditangguhkan:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Defer End Date / Tarikh Tamat Ditangguhkan:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Reason of Deferment / Sebab Penangguhan:
*
Please Select / Sila Pilih
Schooling / Persekolahan
Holiday / Bercuti
Health / Condition Kesihatan
Other / Lain-lain
Please state / Sila nyatakan:
*
View DSA Learn to Swim Calendar
2nd Student Full Name / Nama Penuh Pelajar Kedua:
2nd Student Effective Term / Tempoh Bermula Pelajar Kedua:
*
Please Select / Silap Pilih
Term 1
Term 2
Term 3
Term 4
Term 5
Term 6
Term 7
Term 8
Term 9
Term 10
Term 11
Term 12
Term 13
Term 14
Term 15
2nd Student Defer Start Date / Tarikh Bermula Penangguhan Pelajar Kedua:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
2nd Student Defer End Date / Tarikh Tamat Penangguhan Pelajar Kedua:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
2nd Student Reason of Deferment / Sebab Penangguhan Kelas Pelajar Kedua:
*
Please Select / Sila Pilih
Schooling / Persekolahan
Holiday / Bercuti
Health / Condition Kesihatan
Other / Lain-lain
Please state / Sila nyatakan:
*
3rd Student Full Name / Nama Penuh Pelajar Ketiga:
3rd Student Effective Term / Tempoh Bermula Pelajar Ketiga:
*
Please Select / Sila Pilih
Term 1
Term 2
Term 3
Term 4
Term 5
Term 6
Term 7
Term 8
Term 9
Term 10
Term 11
Term 12
Term 13
Term 14
Term 15
3rd Student Defer Start Date / Tarikh Bermula Penangguhan Pelajar Ketiga:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
3rd Student Defer End Date Tarikh Tamat Penangguhan Pelajar Ketiga:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
3rd Student Reason of Leave / Sebab Penangguhan Kelas Pelajar Ketiga:
*
Please Select / Sila Pilih
Schooling / Persekolahan
Holiday / Bercuti
Health / Condition Kesihatan
Other / Lain-lain
Please state / Sila nyatakan:
*
Back / Kembali
Next / Seterusnya
Contact Information / Maklumat Hubungan
Contact Number / Nombor Telefon:
*
-
Country Code / Kod Negara
Phone Number / Nombor Telefon
Alternate Contact Number / Nombor Telefon Kedua:
-
Country Code / Kod Negara
Phone Number / Nombor Telefon
Email Address / Alamat E-mel:
*
example@example.com
Current Date / Tarikh:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Back / Kembali
Next / Seterusnya
Term & Conditions / Terma & Syarat
I hereby confirm that I have read and agree to the above terms and conditions. The rest of the terms and conditions of service of DSA Programs in general and/or DSA Baby & Me, Learn to Swim, Special Care Swimmer, DSA Learn to Synchro Programs DSA Little Mermaid Program and/or DSA Squad & Water Polo Programs shall be adapted and read herein. Saya dengan ini mengesahkan bahawa saya telah membaca dan bersetuju dengan terma dan syarat di atas. Baki terma dan syarat perkhidmatan bagi Program DSA secara umum dan/atau Program DSA Baby & Me, Learn to Swim, Special Care Swimmer, DSA Learn to Synchro, DSA Little Mermaid serta/atau Program DSA Squad & Water Polo adalah diguna pakai dan dibaca bersama dokumen ini.
*
Submit / Hantar
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