Section 41

Cameron Highlands

PPBM 0080/08

D/A Pejabat Belia Dan

Sukan Daerah Cameron

Highlands, Jalan Masjid,

39000 Tanah Rata,

Pahang 10.3.2008

P.U. (B) 599 7

Bil./

Nama Pertubuhan

Berdaftar/

Name of Registered

Youth Societies

No. Sijil

Pendaftaran/

Certificate of

Registration No.

Alamat/

Address

Tarikh

Pendaftaran/

Date of