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MASJID BENCOOLEN SCHOOL HOLIDAY PROGRAMME - NOV/DEC 2021 (REGISTRATION CLOSED)
REGISTRATION FORM - KINDLY SUBMIT 1 FORM FOR EACH CHILD
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GENDER
*
MALE
FEMALE
FULL NAME AS PER NRIC / FIN / BIRTH CERT
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Your answer
NRIC / FIN / BIRTH CERT
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Your answer
AGE
*
Your answer
LEVEL OF STUDY
*
Choose
KINDERGARTEN
PRIMARY
SECONDARY
RESIDENTIAL ADDRESS
Your answer
POSTAL CODE
Your answer
EMAIL ADDRESS
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Your answer
PARENT'S / GUARDIAN NAME
*
Your answer
CONTACT NUMBER (MOBILE)
*
Your answer
CONTACT NUMBER (HOME)
Your answer
WHATSAPP NUMBER - USTAZ/USTAZAH REGULAR COMMUNICATION WITH STUDENTS
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Your answer
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