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SILA TANDAKAN ( / ) DIPETAK YANG DISEDIAKAN BAGI KURSUS YANG DIIKUTI.

PLEASE TICK ( / ) ACCORDING TO THE COURSE CHOSEN

KURSUS INTENSIF BAHASA ARAB

SIJIL KEMAHIRAN KIBLAT

ARABIC INTENSIVE COURSE

CERTIFICATE OF COMPETENCY IN THE KNOWL. OF QIBLAH

ENGLISH LANGUAGE PROFICIENCY COURSE

SIJIL KEMAHIRAN WAKTU SOLAT

KURSUS BAHASA MANDARIN

SIJIL KEMAHIRAN TAQWIM & CERAPAN

MANDARIN LANGUAGE COURSE

CERT. OF COMPETENCY IN THE KNOWL. OF TAKWIM & FALAK

KURSUS BAHASA JEPUN

SIJIL PEND. AWAL KANAK-KANAK

JAPANESE LANGUAGE COURSE

CERTIFICATE OF EARLY CHILDHOOD EDUCATION

KURSUS PENGAJIAN AL- QURAN TAJWID TATBIQI

SIJIL SENI REKA GRAFIK

CERTIFICATE IN TAJWID TATBIQI

CERTIFICATE IN GRAPHIC DESIGN

KURSUS TADABBUR AL-QURAN (TAFSIR)

SIJIL ASAS ANIMASI

TAFSIR AL-QURAN COURSE

CERTIFICATE IN BASIC ANIMATION

KURSUS PENGAJIAN QIRAAT

SIJIL ASAS PERAKAUNAN

QIRAAT ALQURAN COURSE

CERTIFICATE IN BASIC ACCOUNTING

KURSUS KEMAHIRAN KAUNSELING

CERTIFICATE IN EFECTIVE BUSINESS

WRITING

CERTIFICATE IN COUNSELLING SKILLS

CERTIFICATE OF COMPETENCY IN THE TIMING OF SOLAT

MODUL / MODULE : ________________

A.
BIODATA DIRI / PERSONAL DETAILS
NAMA (DATO/PROF/DR./PUAN/ENCIK/CIK) : ________________________________________________
NAME

NO.KAD PENGENALAN

: _______________________________________________________________

I/C NUMBER

ALAMAT SURAT

: _______________________________________________________________

MAILING ADDRESS

MENYURAT

_______________________________________________________________

MAILING ADDRESS

NO. TELEFON

: ________________________ (R/ H) ________________________ (HP/MOBILE)

TEL. NO.

E-MAIL

: _______________________________________________________________

E-MAIL

PEKERJAAN

: _______________________________________________________________

OCCUPATION

ALAMAT MAJIKAN

: _______________________________________________________________

EMPLOYERS ADDRESS

SUMBER MAKLUMAT BERKAITAN KURSUS : _______________________________________________

INFORMATION SOURCES

B.

MAKLUMAT WARIS / ORANG YANG DIHUBUNGI SEMASA KECEMASAN

IMMEDIATE FAMILY TO CONTACT

NAMA

: ______________________________________________________________________

NAME

NO. TELEFON

: ________________________________________

TEL. NO.

SAYA MENGAKU BAHAWA SEGALA MAKLUMAT YANG DIBERIKAN DI ATAS ADALAH BENAR.
I DECLARE THAT ALL THE INFORMATION ABOVE IS TRUE

TANDATANGAN: _______________________

TARIKH: _____________________

SIGNATURE

DATE

UNTUK KEGUNAAN PEJABAT

BAYARAN

: RM____________________

NO. RESIT

: _____________________

PENERIMA

: _______________________

TARIKH

: _____________________

BAKI

: RM____________________

CATATAN

: _____________________