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Home
About Us
President
Vision & Mission
Objectives
Initiatives
Food Assistance Program: Panthi Idu Pasi Aatru
We Are Listening
Help Directory
Strategic Partners
Temple Affiliates
Academic Partners
NGO Partners
Government Partners
Media Partners
Volunteers
Gallery
Panthi Idu Pasi Aatru
Social Activities
Other Activities
Contact Us
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Registration
Name
*
CITIZENSHIP
CITIZEN
NON-CITIZEN
MYKAD NUMBER
*
EMAIL ADDRESS
HOUSE ADDRESS
CITY
STATE
*
SELECT
PERLIS
KEDAH
PENANG
PERAK
PAHANG
SELANGOR
TERENGGANU
NEGERI SEMBILAN
MELAKA
JOHOR
SARAWAK
SABAH
W.P PUTRAJAYA
W.P KUALA LUMPUR
W.P LABUAN
GENDER
MALE
FEMALE
OTHERS
PHONE NUMBER
*
MARITAL STATUS
*
SELECT
SINGLE
MARRIED
DIVORCEE
WIDOW
OCCUPATION
SELECT
UNEMPLOYED
SELF EMPLOYED
GOVERNMENT
PRIVATE
OTHERS
OTHER OCCUPATION
*
COMPANY NAME
COMPANY ADDRESS
HOUSEHOLD INCOME
*
SELECT
BELOW RM 2000
RM 2000 - RM 5000
RM 5000 - RM 12000
ABOVE RM 12000
REFERRED BY (IF APPLICABLE)
TYPE OF ASSISTANCE
*
HEALTH
EDUCATION
WELFARE
CITIZENSHIP
ENTREPRENEURSHIP
OTHERS
TYPE OF ASSISTANCE
*
HEALTH
EDUCATION
WELFARE
CITIZENSHIP
ENTREPRENEURSHIP
OTHERS
PURPOSE OF REACHING OUT - HEALTH
*
MEDICAL AND HEALTH REPORT
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INSURANCE COVERAGE
*
YES
NO
OTHER SUPPORT
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GOVERNMENT BODY
NGO
ADUN OFFICE
MP OFFICE
NONE
SUPPORTING DOCUMENTS (PAYSLIP/ OKU CARD/ JKM)
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PURPOSE OF REACHING OUT
UPU APPLICATION GUIDE
APPEAL TO UPU APPLICATION ( RAYUAN )
PATHWAY TO EDUCATIONAL GUIDANCE
OTHER REASON
OTHER REASON
*
SPM/STPM RESULTS
MATRICULATION/FOUNDATION/DIPLOMA RESULT
UPLOAD ABOVE MENTIONED RESULTS DOCUMENT
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PURPOSE OF REACHING OUT - WELFARE
*
PAYSLIP
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NUMBER OF DEPENDENTS
*
IC COPY OF DEPENDENTS
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OTHER FINANCIAL SUPPORT RECEIVED
SELECT
NONE
GOVERNMENT BODY
NGO
STATE THE NAME OF FINANCIAL AIDER
*
PURPOSE OF REACHING OUT - CITIZENSHIP
IC
BIRTH CERTIFICATE
PURPOSE OF REACHING OUT - ENTREPRENEURSHIP
*
NATURE OF BUSINESS
*
COMPANY NAME
SSM
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PURPOSE OF REACHING OUT - OTHERS
*
SUPPORTING DOCUMENTS
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