a-::.-_
Registration Sheet
ffi Mffiffi- *ilruTilffi fu#
Ailv&ir+E * tHArr*r ,1."..R-
ilic.
i
F.i$difi
Health & Safety Regulatory Compliance 16th February 201,6 Duration: 0B Hours
i*J* {HArrl*t.
lWru ruONTH SOUTH UNIVERSITY
Note:
L
Please write your
2.
3.
SI
full name in BLOCK LETTERS and ensure that you have spelled it correctly and provided adequate spacing in between your names. Please be informed that the way you will write your name in this sheet is how it will be printed on the Certificate that will be awarded to you; and therefore you are requested to write your name in a manner that is readable to us. Once we have printed the Certificate with the information you provided in this document, no requests with regards to change of spelling, separating the first name from last name or spacing in between names shall be entertained. Photograph of the training will be used in printing and online materials.
Name
Email Address
&
Organization
Signature
no.
Cell Phone Number
1
Ma+. 6nrqrrqn guurnnr 0l?16- ls6\oo
{^Ad,"/ 2.
EHs
&-.4/ee196'u
w_
4
'&lhne6'1
t6257/7 e rt25 L( 57"6
ffi,qMt)( ,i(rttry
0t?5
H"k/.
,rytr
"
3.
ALA
4.
Ll.*.r^-.r1 '{s[c,-'
h".!i.r\,t*atn rp"f@ X",i1 'Qcm
t\4
S^,'1.ri
0
'
Y1 0l-1Al'1 l"t AD Ur
5.
S
LlD,SHAFIUL
*
(c'r{'\^ E"rrt G
\9lr-f9\1Sr{
oll^ *r"ra.l-*ba' /a @y,l*
G" u)
f
ss.^,$rr\ A-b^dl1'
ta"L4ag331' o r I t5-9ri Z-t 1 o
tt"t'
g{"otJ$4"4sr x-,a)as
olq(,oo LL\ bE b\7t94aA 3\j 'i
xh\c,
ahA.o-f
\\
Gh
&tltr?'lb Mr* -YT
Registration Sheet
- ,:irri!
{: #Iq: ' s^'tI*;. l*, :*4"'" MS$ "-"i\l SI$BN1:St$4u i i"r ful ;iqg: ii._;l j-;ll-:'L fr {". A1 rillli.j\i',ltiil T(.r.l,,Jtt:*, ! !j*rttt ^_-"
t}ti}i.tl'i
Health & Safety Regulatory Compliance 16th Febru ary 201,6 Duration: 0B Hours
lr_
'3:,:li-\,
:1SII NORTH SOUTH UNIVERSITY 'rqllii_iy
SI no.
Email Address &
Name
Organization
Signature
Cell Phone Number
6.
rtr..
M.l, R^s J^eJr"[
7.
'3
tsftSSRE
F Jzant
/;'wu'#,
t Zzrztr--
efa,ru;rrnl/dgr-'(a, Nr;^ fr/tr,/r,,p
Llil.
/ ?6?? ??3C F
067719? ? L2 EABE)ft
ivrRg;h
@-
o/04 55f/q37 o
o
rJ r R -/1 ,,ho,.r! Ll,r
rtd Ral*'rrl$ hrG)
€tlew Mnua
D,{AJ,I
I
M
t4
RPID a.t/t14€D
0@"i/
8.
@q;.,i1 c,
c175637m79
H.'.s nn
Md
L^el1"J r u
pink1.
,lo-te6o.br\./raR
J"\".
. som
e
@
rR"k**.r G*y
@
ol+3\4^e44o ' 10.
,;P;*^k
'Fo!s*
^ sk^kL^,s*
SvJa-1rrzn
@t$19
11
sicldiftL(
Alarn
'r
@ 'y^Loo
hrr-2:a Nr u,A,Un Q ahw. cor^ 1
+*'
ios\- -
tast-)
i6lb
t"*I
\tt
X?t
w-/ ,r--i\
f
M**
,r,ld*gul,.(o*oofl
o
y
14r778 frrx{r'nyt
t(-l.
o17t6;LVt>l HuuaqtqaT1 zArri( L'DDirx (pi3 no{- si r
f\4 14
LerW-
VnuY,Carru
12
"
.
At^.'^E
.JL
-"7 ^lkdp
l$,\ ,"__.-$
'?'t...
urr],;*flr*r WM#ffi* r\*.iI;\ $*S}*kW, ,\hJilJri;,,
,lf'."j\li.);;;,..,"
:Eil Sl no.
Registration Sheet Health & Safety Regulatory Compliance 16th Febru ary 2A1,6 Duration: 0B Hours
r
i r_:=,
j,,r,,
*'
'
"
ruonru sourH uNrvERSrry
nmaitAod.ffi
Name
Organization
Signature
CeIl Phone Number
13"
naurozf.{g)ihHr.
Naur.6g f^rl"N N,rp
t'ei{q
6t7t-7w3 t% 14.
,^-^
Fr,{"I Vl,^nlor)
.r^-
@ 6rr*1.d,
I
{vlo,t*qn@TA;A
[h.lr-"J
*,
fi.ulioa
t+4
W*'n15.
P/.,r,
I {A*eurr,-/rk
to*"rsr'ph/oauft"z bd
@f-;/'Qarrt
l,'{.."p"
l
16.
Ul.rar.ttt E-,"; hq)^^ x TL.,r"zbo*n-^o^,-
LUD P4KLra -{Jp/r,---r*
Y'Ctrv17.
'18
t'\d.Zdw,i^ Vlrlel Ma. V4 t4,)\t^r-
(^sl;J
t l^AnL; iL@ n\i../r1 u r\ oga
/
Q
fi
c6y,,
frw,A,/.
ur-1.
e^ ro
C"br
p",(^Vt t
lr
ia|
F,-sI.,
o
,"
L.i-*.
oiVt) n1zii1
19.
N0 .
r,l0R0l I SLAIy
clv.rn
0{
@ y,,Uo;
oletB- q:lLqg\
**-ar 20.
N4l+Nt\)i)
u,.l'o-l-_,rr
hrrn @ r"h*. y
c t)rt.jTyisg
o
r,--
Nippon
Pa in
l-
@E P"r-, La 5ftda.^,f
,Boe7
fr/-(
+* tu. Q'F*,,"
Registration Sheet q:1,
!r#""if
n* ::1 e(::'\.
P5,:i Uryr,r.^.ll'-s' *,q* ; . """'
, Lt
ir^ i i
t.., i""": ffitr"3dp 'l i .t 1" i. :Ji\ii i l.i:i. .ri' I;'t! r.l'.^ :
,r1|$.
i;j,@j, "&l !/
Sl no.
: ,
"
i
F
Health & Safety Regulatory Compliance L6th February 201,6 Durationr 0B Hours
""
i"..il',
.i
wonrH sourH UNTVERSITY
Email Address &
Name
Organization
Signature
CeIl Phone Number
!1> 21.
u AsuDu'F--
0--AHrL'\AtV
(r&t<'nal seleete'l 'J 22.
23.
24.
25.
26.
27.
28.
A-c 'lr ar'rr , /1
)
v"'^\
cLcL>Lr**1eO*,,t B<'rrq
fu
Lroio:o\12.-b-S)Tah?
{ln
u>,1{n
