e-Education (User Education Program Form)

USIM/PERP/PU/01/1 Pind. 2

Reference Unit
USIM Library
Tel: 06-798 6243/ 6245
Fax: 06-799 3508

TO BE COMPLETED BY PATRON.

PERSONAL DETAILS.

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PROGRAM DETAILS. (1 hour for each class).

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To
If you need addtitional class for another 1 hour, please specify at below:
List Name of Patron.
Minimum 5 persons for student/ No minimum limit for staff:

Please submit this form within 3 working days before the expecting date of class.
 
Further information, do not hesitate contact:
 
Person in charge: Pn. Wan Azura binti Radzuan
Telephone: 06-798 6245
Email: wnazurard@usim.edu.my
 
Your request will be confirm through email or telephone.
 
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