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Butiran Bantuan Yayasan Amal ASAS (YAA)
Butiran lengkap ini diperlukan untuk penilaian sebelum bantuan diberikan.
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* Indicates required question
Nama Penuh (seperti kad pengenalan)
*
Your answer
Email
*
Your answer
Alamat tempat tinggal semasa
*
Your answer
Nombor telefon
*
Your answer
No K/P
*
Your answer
Tahun keluar SAS
*
Your answer
Negeri
*
Your answer
Bantuan Zakat/Perkeso dll
*
Choose
Ya
Tidak
Jika Ya nyatakan jumlah
Your answer
Pendapatan bersih (RM)
*
Your answer
Akaun bank
*
Your answer
Nama Bank
*
Your answer
Tanggungan (Isteri/Suami, anak, umur)
*
Your answer
Keperluan
*
Your answer
Cerita Ringkas
*
Your answer
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