祝福文化3月11-12日組團去霹靂送暖,歡迎報名參加!
日期: 2023年3月11日-12日      目的地:霹靂
團費:含巴士、酒店(雙人房)、3月11日午和晚餐、12日早餐(午餐將安排在茶室自行解決)、保險費及捐贈物品等費用。
            A. 吉隆坡出發:RM 500
            B. 怡保出發(住宿酒店):RM450
            C. 怡保出發(不住宿酒店):RM 350

集合地點和時間:1. 吉隆坡: 3月11日,9:30am, 祝福文化辦公室樓下  (Wisma Mirama) 。
                                2. 怡保:3月11日,大約中午 12:00pm。(地點稍後通知)。

報名截止日期:2月28日(名額有限 ,如截止日期前額滿,將終止接受報名。)
Sign in to Google to save your progress. Learn more
中文名字
Chinese Name
英文名字 *
English name
性別 *
身分證號碼 *
Identity card no.
郵寄地址 *
Correspondence address
聯絡電話 *
Contact no.
電郵 *
Email Address
葷食/素食 *
Non-vegetarian / Vegetarian
緊急聯絡资料
Emergency contact details
緊急聯絡人名字 (英文) *
Emergency contact person (English)
緊急聯絡人電話號碼 *
Emergency contact
旅遊保險
Travel  Insurance
保險受益人英文名字(如身份證顯示) *
Insurance Beneficiary English Name (As show in Identity Card)
受益人身份證號碼
*
Beneficiary‘s Identity Card Number
與受益人的關系
*
Relationship between you and beneficiary 
付款資料
Payment details
數額(RM) *
Amount (RM)
支付方式 *
Payment method
若選擇支票/銀行匯票/郵政匯票,請填寫銀行名字與支票號碼/匯票號碼:
If payment by cheque / bank draft / postal order, please provide name of bank and cheque number / document number :
若選擇銀行匯款/網上轉賬,請填寫匯款日期和時間:
If payment by direct bank transfer or online banking, please provide transfer date and time :
MM
/
DD
/
YYYY
Time
:
請填寫相關戶頭名字與號碼:
Please provide account name and number for reference.
付款說明
Payment Description

i. 銀行匯款 / 網上轉帳
Best Wishes Foundation 
RHB Bank 212479-00057559
**請務必將匯款單據bank in slip電郵至charitybestwishes@gmail.com

ii. 支票/銀行匯票/郵政匯票
抬頭誌明: Best Wishes Foundation
請寄至下址:
The Trustees of Best Wishes Foundation Registered
10th Floor, Wisma Mirama, Jalan Wisma Putra, 50460 Kuala Lumpur.

【我們將在確認款項過賬以後,把正式收據電郵給您。】
責任書
Responsibility Statement 
如旅途中染病或發生意外,本人和親屬將不會追究祝福文化基金會的責任。(請填寫身份證號碼代替簽名)  
In the event of illness or accident during the trip, I and my relatives will not hold The Trustees of Best Wishes Foundation Registered responsible.  (Please fill in Name or Identity Card No. respresent signature.)
參團者名字與簽名    
*
Member's Signature 
親屬名字與簽名
*
Relative's Signature 
與親屬的關係
*
Relationship between member and relative
留言
Remark
欲知更多詳情,請聯絡我們:
祝福文化基金會 The Trustees of Best Wishes Foundation Registered(PPAB-22/2015)
Address:10th Floor, Wisma Mirama, Jalan Wisma Putra, 50460 Kuala Lumpur.
Tel: +6 016 678 5022  (10:30am~4:00pm)
Email: charitybestwishes@gmail.com
Website:www.bestwishes.com.my
Facebook:www.facebook.com/bestwishes.cc
祝福文化基金会将严格遵守PDPA 法令,决不泄漏此表格上的个人资料。

Any personal data shared in this form will be treated by Best Wishes Foundation in accordance with the requirements of the PDPA.  
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy