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
Field is required!
Field is required!
Nombor MYKAD
Nombor MYKAD
Field is required!
Field is required!
Nombor Telefon
Nombor Telefon
Field is required!
Field is required!
Nombor Whatsapp
Nombor Whatsapp
Field is required!
Field is required!
Email
Email (Jika ada)
Field is required!
Field is required!
Permohonan Sebagai
Field is required!
Field is required!
Pekerjaan
pekerjaan
Field is required!
Field is required!
Pendapatan Bulanan (RM)
Pendapatan Bulanan (RM)
Field is required!
Field is required!
Alamat Penuh Kediaman
Alamat Penuh Kediaman...
Field is required!
Field is required!
Poskod
Poskod
Field is required!
Field is required!
Daerah / Jajahan
Daerah / Jajahan
Field is required!
Field is required!
Negeri
Field is required!
Field is required!
Jenis Bantuan Diperlukan
Field is required!
Field is required!
Maklumat Berkaitan
Isi Maklumat Berkaitan...
Field is required!
Field is required!
Sila Selfie Wajah Penuh Anda Sambil Pegang MYKAD
Sila Selfie Wajah Anda...
Field is required!
Field is required!
Gambar MYKAD Bahagian Depan
Gambar MYKAD Bahagian Depan...
Field is required!
Field is required!

Perhatian : (Kami kekurangan DANA, Hanya Pemohon Hanya Yang Layak Sahaja Selepas Penapisan akan Diluluskan) – HANYA WHATSAPP AKAN DILAYAN – NO VOICE CALL

0:00
0:00
Scroll to Top