MALAYSIA 2014 WORLD YOUTH STAMP EXHIBITION EXHIBIT APPLICATION FORM 1 - 6 DECEMBER 2014

Class 1 Yo !" P"#la!$l%

Fill in a separate form for each exhibit. Please print or type in block letters. This Exhibit Application Form must be returned through the Commissioners

Class 2 T"$&a!#' P"#la!$l% Class - Mo.$/+ P"#la!$l% 0o1 21s! C$+! /%2

to reach the Commissioner General by 11 April !1" at the address belo#$ Address c8o 0ak ?ok Cheong= .eputy Commissioner General= * @alan /3@ "810= "A&!! 3ubang @aya= 3elangor = 0alaysia Telephone Email %&! 1' '(!)!"* #orldyouth !1"Bgmail.comC lkcmakByahoo.com

First Time Entry $+es F-P -.E,T-T+ ,/01E2$ 0r 0iss Pseudonym Address

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Tel Fax Email

3urname .ate of birth 4for youth exhibitors5

First ,ame Telephone Email Fax

Title of this exhibit 4in English5

Pre6ious title

3hort description of the exhibit 4in English5

-ntroduction page included Exhibit class

+es

,o .imensions of sheets 4in cm5 1 PAST AWARDS RECEI(ED 9G A A7 17 : 93 3 31 1

,umber of frames applied for

-nternational F-AP8FEPA8F-AF8 ;orld 4F-P5 Exhibitions

9:

,ational Exhibitions

The undersigned 4Exhibitor5 hereby 415 agrees to accept all F-P 2egulations 4G2E<= G2E:= 32E:35 and the indi6idual regulations 4-2E<5 applying to 0A9A+3-A !1" 4 5 confirms that the exhibit is o#ned by me 4G2E< Article 11. 5 .ate Commissioner>s declaration 2emarks 3ignature

.ate E)"#*#!#o+ ($+ $,

3ignature ?uala 9umpur Con6ention Centre Exhibition Dall 1 E 4Address$ @alan Ampang= )!!(( ?uala 9umpur= ;ilayah Persekutuan ?uala 9umpur= 0alaysia5 The exhibit #ill be deli6ered by commissioner.

F/a&$ F$$s$ Class 1 FreeC Class E ' /3F)! per frame