KPMG Cyber Security Challenge Registration Form

Team Name (this will be used as your account ID during the challenge day)
Please provide 2 options in case account ID is already in use. Account ID needs to be Alpha-numeric and contain 4-16 characters. You may use capital letters
and non-capital letters. Please refrain from using spaces, instead use dashes or underscores.

Option 1: Yes ( Selected option 1) Option 2:

Please enter your team details below. 1st name is team captain and main point of contact.

No Full Name as per IC IC/Passport Email Contact number University/College Major T-Shirt Size

1
Mohammad Mostafizur Rahman BP0007529 mostafiz1333@gmail.com +60114294980 Universit Islamic Antarabangsa CS L
2
Steve Oskar BT0042270 steveoskar12@gmail.com +60142399757 Universit Islamic Antarabangsa CS M
3
Sanjir Salsabil BP0542282 sanjirsalsabil1@gmail.com +60112136050 Universit Islamic Antarabangsa CS M
4 Sheikh Md Hanif Hossain BT0032211 sheikhhanifhossain@gmail.com +60182516495 Universit Islamic Antarabangsa CS M

Kindly email completed registration form to syuhaidamohdzaine@kpmg.com.my by 19 October 2018.

Participation in the KPMG Cyber Security Challenge constitutes you and your team members' full and unconditional agreement to and acceptance of the Terms
and Conditions. For full terms and conditions, please visit www.kpmg.com.my/cyberchallenge

T-Shirt Size Measurements

XS Shoulder: 16” Chest: 36” | S Shoulder: 17” Chest: 38” | M: Shoulder: 18” Chest: 40” | L: Shoulder: 19” Chest: 42” | XL: Shoulder: 20” Chest: 44”

Emergency Contact Person:

Name: Mohammad Mostafizur Rahman Mobile No.: +601114294980

© 2018 KPMG Management & Risk Consulting Sdn. Bhd., a company incorporated under Malaysian law and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
The organizer reserves the right to amend the program and/or components of the competition where necessary without prior notification. The Terms and Conditions (“T&C”) are provided online at www.kpmg.com.my/cyberchallenge. You are deemed to have read and understood the
terms and conditions upon submitting this registration form. To view our privacy policies, visit www.kpmg.com.my/privacy