APPLICATION FORM FOR RPL SERVICE

Application Form Number:AOA 101

Company/Agency Name:

Address:

Tel:

Fax NO:

Email*:

Start Using On (dd/mm/yy) *:

Type of Application:  New Application  Additional

Type of system X, β, γ

Full Name IC Number (New) Position
+add field

Officer in Charge:

Terms and Conditions

1. The OSL Badge: F.O.C by loan basis, the badge belong to Nuclear Malaysia Agency.

2.Registration Fees:
– The Current Film Badge user: F.O.C
– New and additional user: RM 80.00 per person

3. The Analysis fee service: RM 18.00 per person/month

4. The penalty of OSL Badge lost: RM 150.00/badge

5. Postage charge using Poslaju for OSL Badge:
***Not include 6% GST charges

NO QUANTITY PRICE (RM)
PENINSULAR SARAWAK SABAH
1 Less than 20 PCS 14.00 23.00 27.00
2 21 PCS – 40 PCS 20.00 33.00 39.00
3 41 PCS – 60 PCS 26.00 43.00 51.00
4 61 PCS – 80 PCS 32.00 53.00 63.00
5 81 PCS – 100 PCS 38.00 63.00 75.00
6 Additional every 20 PCS +6.00 +10.00 +12.00

 I Agree to the Terms and Conditions

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