Securities Industry Development Corporation

Bumiputera Training Fund Course Registration Form

Participant Details

Name

NRIC

Tel No.

Address 1

Address 2

City

Postcode

Country

State

Company

Designation

Company Contact Person Details

Name

Designation

Tel No.

Course Details

Course

Date

Fee

Training Provider

Venue

Reason(s) for attending the course

CPE Information

CPE Points

CPE

Non-CPE

CMSRL No.

CMSRL Expiry Date

CPE-Approved Training Provider / Organiser

Item A

Yes

No(If No,please complete Item B. below)

Item B

I hereby declare that the Training Provider/Organiser has been in operation for at least two (2) years from the date of the application.

Name

Designation

Date

Declaration and Signature

I have read and agreed to abide to the BTF T&C stated in this form.

I hereby declare that I have given my consent to the processing of my personal data in accordance with the Notice under the Personal Data Protection Act 2010.

Require to submit CMS Report

Yes

No(If No, Fill in the justification)

SIDC’s Capital Market Competency Management System Assessment report

Justification

Bumiputera Training Fund Course Registration Form

CPE-Approved Training Provider / Organiser

Submit

Submit

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