Covid-19 - Relief Application Form / Borang Permohonan Bantuan
// ATTENTION //

iElder.asia understands the challenges and current issues faced by elderly care operators during this Covid-19 pandemic. As such, we have started a fundraising campaign on our website to allow members of the public to purchase charity gift cards to assist in donating basic supplies and protective equipment for those in need. We request the cooperation of care centers, old folks homes, and nursing homes who need aid/assistance to complete this form to facilitate the effort in a prudent and responsible way. Thank you.

// PERHATIAN //

iElder.asia memahami cabaran dan isu semasa yang dihadapi oleh pengendali penjagaan warga tua semasa ancaman pandemik Covid-19 ini. Oleh itu, kami telah memulakan kempen pengumpulan dana di laman web kami untuk membolehkan orang ramai membeli kad hadiah amal untuk membantu menyumbangkan bekalan asas dan peralatan perlindungan bagi mereka yang memerlukan. Kami meminta kerjasama pusat jagaan, rumah orang tua, rumah jagaan atau mana-mana pihak yang memerlukan bantuan / pertolongan boleh melengkapkan borang ini untuk memudahkan usaha dengan cara yang berhemah dan bertanggungjawab. Terima kasih.
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1. Name of Applicant // Nama Pemohon *
2. Sex of Applicant // Jantina Pemohon *
3. Contact Number of Applicant // No. Telefon Pemohon *
4. E-mail of Applicant // E-mel Pemohon *
5. Designation of Applicant // Jawatan Pemohon *
6. Are you the official representative for the aforementioned premise? // Adakah anda wakil rasmi untuk premis berkenaan? *
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