First Aid at Workplace Registration Form

✅ 2-day training 8.00 am – 5.00 pm
✅ Convenient venue, next to Cochrane MRT (Google map: https://g.page/SJAMalaysia)

✅ Certificate of Competency (3 years validity)

✅ Theoretical test and practical skills assessment

Name as per MyKad or Passport *

MyKad/Passport Number *

Please enter your MyKad / Passport number in the format: XXXXX-XX-XXXX, with dashes separating the digits

Email *

Phone *

Invoice to be issued under individual's name or Company name? *

Individual's name

Company's name

Organization *

Address *

City *

Postal code *

State *

Business Email *

Company PIC Phone Number *

I agree with the Terms and Conditions as stipulated at the website at http://firstaid.sjam.org.my/tnc