[TEST] Template Form Testing

Date of Event

Day

Month

Year

Please be advised that this event will be conducted in English
This event is for ONLY
Ages to

BILLING INFORMATION

Full Name*

E-mail*

Phone*

Number of Participants*

This event is fully booked.

Donate to support our cause at bit.ly/infaq2021

#1 PARTICIPANT DETAILS

Same as in 'Billing Information'

Participant #1 is the same as 'Billing Information'

Full Name
Same as in 'Billing Information'

Phone Number
Same as in 'Billing Information'

E-mail
Same as in 'Billing Information'

Full Name*

Phone Number*

Please include the country code as well (e.g. +60123456789)

E-mail*

An info pack will be sent via email upon registration

Enter Email Confirm Email

Age*

Gender*

Male
Female

State*

International*

#2 PARTICIPANT DETAILS

Full Name*

Phone Number*

Please include the country code as well (e.g. +60123456789)

E-mail*

An info pack will be sent via email upon registration

Same as email(s) above
Enter a different email

Enter E-mail Address*

Enter Email Confirm Email

Age*

Gender*

Male
Female

State*

International*

#3 PARTICIPANT DETAILS

Full Name*

Phone Number*

Please include the country code as well (e.g. +60123456789)

E-mail*

An info pack will be sent via email upon registration

Same as email(s) above
Enter a different email

Enter E-mail Address*

Enter Email Confirm Email

Age*

Gender*

Male
Female

State*

International*

#4 PARTICIPANT DETAILS

Full Name*

Phone Number*

Please include the country code as well (e.g. +60123456789)

E-mail*

An info pack will be sent via email upon registration

Same as email(s) above
Enter a different email

Enter E-mail Address*

Enter Email Confirm Email

Age*

Gender*

Male
Female

State*

International*

PROGRAMME FEES

Your placement is only confirmed when payment is fully paid
Placement is by first-come first-served basis
Any payment made will not be refunded
Upon confirmed registration and payment, we will email you further details of the event
For further clarification please contact us via WhatsApp: +60104551034 or email us at: events@alkhaadem.com

Price

Price: RM 300.00

Total Fees

RM 0.00

PAYMENT METHOD

Choose Payment Method*

Please transfer the total amount to: 5623 5711 4347 FOQUS AKY SDN BHD (Maybank)

Keep the payment slip and upload it below:

Upload Proof of Payment*

Where did you hear about this programme?*

Al-Khaadem Facebook
Al-Khaadem Instagram
Al-Khaadem Whatsapp broadcast
Al-Khaadem events/programmes
Al-Khaadem Website
Qalby App
Recommendations from others
Others

Who?*

(Family, friend, co-worker, etc.)

Others*

[TEST] Template Form Testing

[!TEMPLATE] [PILLAR] Al-Khaadem Program

Please be advised that this event will be conducted in English This event is for ONLY Ages to

BILLING INFORMATION

This event is fully booked.

#1 PARTICIPANT DETAILS

#2 PARTICIPANT DETAILS

#3 PARTICIPANT DETAILS

#4 PARTICIPANT DETAILS

PROGRAMME FEES

PAYMENT METHOD

Please be advised that this event will be conducted in English
This event is for ONLY
Ages to