[TEST] Template Form Testing [!TEMPLATE] [PILLAR] Al-Khaadem Program 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 INFORMATIONFull Name*E-mail* Phone*Number of Participants*1234This event is fully booked. Donate to support our cause at bit.ly/infaq2021#1 PARTICIPANT DETAILSSame 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*MaleFemaleState*Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaLuar Negara (Outside Malaysia)#2 PARTICIPANT DETAILSFull Name*Phone Number*Please include the country code as well (e.g. +60123456789)E-mail*An info pack will be sent via email upon registrationSame as email(s) aboveEnter a different emailEnter E-mail Address* Enter Email Confirm Email Age*Gender*MaleFemaleState*Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaLuar Negara (Outside Malaysia)#3 PARTICIPANT DETAILSFull Name*Phone Number*Please include the country code as well (e.g. +60123456789)E-mail*An info pack will be sent via email upon registrationSame as email(s) aboveEnter a different emailEnter E-mail Address* Enter Email Confirm Email Age*Gender*MaleFemaleState*Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaLuar Negara (Outside Malaysia)#4 PARTICIPANT DETAILSFull Name*Phone Number*Please include the country code as well (e.g. +60123456789)E-mail*An info pack will be sent via email upon registrationSame as email(s) aboveEnter a different emailEnter E-mail Address* Enter Email Confirm Email Age*Gender*MaleFemaleState*Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaLuar Negara (Outside Malaysia)PROGRAMME FEESYour 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 METHODChoose Payment Method*Online Transfer (FPX)Credit/Debit Card (Visa/Mastercard Only)ATM / Direct Transfer 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 Qalby App Recommendations from others Others Who?*(Family, friend, co-worker, etc.)Others*
