Registration Form

REGISTRATION FORM - THEtreeRU

TO Teddy Dielenberg , Suite 18, Ixora Residence, Jalan Jenjarum, Petaling Jaya, 47400 Selangor, MALAYSIA
Fax + (603) 8023 2082 – Email:
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NAMES ………………………………………………………………….. No of persons…………..

Spouse’s name / attending ………………………………................ ……………….……… ………

Address ………………………………………………………………………………………………

…………………………………………………………………………………………………..………

Contacts : Tel / Mobile ………………………….. E-mail ……….…………………………………

HOTEL ACCOMMODATION required / not required - Dates - IN…………OUT………………

REUNION DINNER – 1-10-10 - NUMBER OF PERSONS ………………………………….

T-Shirt for Self - Size : XXL / XL / L / M / S Colours preferred : Grey / Blue / Orange

T-Shirt for spouse Size : XXL / XL / L / M / S Colours preferred : Grey / Blue / Orange

T-Shirt one free to attendee, if extra pieces required RM20.00 No Pcs … Sizes….Colour preferred

GIFTS EXCHANGE : Each one to bring a gift for exchange. The value not to exceed RM30.00
Please wrap up your gift and it will be exchanged with others, whatever you pick and this is all fun
But if you don’t bring a gift then you are not in the position to exchange.
DOCUMENTS OF MEMORIES, a book will be produced – Please complete the attached Form and please include the necessary photographs. Some of us have not met for 52 years and this book will help many to put things together, Names and Faces. Please send what is required as early as possible as we have a material deadline to produce it. The producer of this DOM is Dave Mokhtar Ramlee and please send the required details and photos directly to him whereas the Registration Forms directly to
Teddy Dielenberg
PLEASE HELP : Register early as we want to make sure all goes well and that we all can have a good
and a fun time at this THEtreeRU . Look, there is no guarantee that we are going to meet at the next Reunion or if there is going to be another one.

FOR FURTHER INFORMATION AND ASSISTANCE PLEASE CONTACT THE FOLLOWING
For Hotel Accommodations , Reunion Dinner, Programs, Details in Documents of Memories & General
Teddy Dielenberg – Tel (H) 603-7880 1489 Mobile 6019-330 5418 – Email :
Dave Mokhtar Ramlee – (H) 604-731 5882 Mobile 6012-495 3484 – Email:
Agnes Teh – Mobile 6012-466 4046 Email :