PERKHIDMATAN HAFEENA SDN BHD

PERKHIDMATAN HAFEENA SDN BHD
Bus Service Booking Form 2015
Please tick ()
( ) New application
( ) Update information
I / We would like our children to use the school bus service.
Please tick () the bus route below:
Common
pick up & drop off
Route
(
(
Rate per term
per student
Pick up time
(estimate)
Drop off time (estimate)
w/o ASA
with ASA
) Gita Bayu
Bus
Gita Bayu Club House
RM 775
8:05 AM
3:45 PM
4:55 PM
) Country
Heights
Bus
Jalan Langit Biru
RM 775
7:40 AM
4:05 PM
5:25 PM
Note:
1) Travelers from Country Heights and Gita Bayu are travelling on the same bus.
Commencement date:
(subject to confirmation of seat availability)
No
Student name
Surname
First name
Gender
Year
M/F
Group
1.
2.
3.
4.
Contact Details
Surname
First name
Parent / Guardian name
Emergency contact person
Residential Address
Parent / Guardian contact number
Home :
Mobile :
Emergency contact number
Home :
Mobile :
Billing Details
Email address
 Yes, I / we have read, understood and agreed to all the bussing terms and conditions in the attached document.
Parent / Guardian Name
Parent / Guardian Signature
Please submit form directly to: Student Services (Bussing) Helpdesk at [email protected] or fax to 03-8949 5100
For further enquiries please contact us at 03-8949 5038
Cheque in favour of: PERKHIDMATAN HAFEENA SDN BHD
Enclosed Cheque No
of RM
being payment for Term
For office use only (acknowledged receipt)
For office use only (acknowledged receipt)
Student Services (Bussing) Helpdesk
Date:
Perkhidmatan Hafeena Sdn Bhd (Lee Hock Phen H/P: 012-210 2944)
Date:
Seat confirmed by bus operator: YES / NO

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