BORANG PERMOHONAN BANTUAN BENCANA BANJIR PERTUBUHAN AMAL KEBAJIKAN,PENDIDIKAN DAN KEMAJUAN INSAN KOTA BHARU

Sila isikan borang Borang Permohonan Bantuan Bencana Banjir Pertubuhan Amal Kebajikan,Pendidikan Dan Kemajuan Insan Kota Bharu di bawah untuk memohon bantuan berkaitan bencana banjir (Individu/Keluarga yang terjejas pendapatan).

Permohonan yang asli sahaja akan dilayan.

Nama Penuh
Nama Penuh Dalam MYKAD
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Nombor MYKAD
Nombor MYKAD
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Nombor Telefon
Nombor Telefon
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Nombor Whatsapp
Nombor Whatsapp
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Email
Email (Jika ada)
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Permohonan Sebagai
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Pekerjaan
pekerjaan
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Pendapatan Bulanan (RM)
Pendapatan Bulanan (RM)
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Alamat Penuh Kediaman
Alamat Penuh Kediaman...
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Poskod
Poskod
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Daerah / Jajahan
Daerah / Jajahan
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Negeri
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Jenis Bantuan Diperlukan
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Maklumat Berkaitan
Isi Maklumat Berkaitan...
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Sila Selfie Wajah Penuh Anda Sambil Pegang MYKAD
Sila Selfie Wajah Anda...
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Gambar MYKAD Bahagian Depan
Gambar MYKAD Bahagian Depan...
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Perhatian : (Kami kekurangan DANA, Hanya Pemohon Hanya Yang Layak Sahaja Selepas Penapisan akan Diluluskan) – HANYA WHATSAPP AKAN DILAYAN – NO VOICE CALL

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