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Permohonan Bantuan ZERO HUNGER
Kepada golongan berpendapatan terkesaan dan ingin memohon bantuan, sila isi borang di bawah.
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* Indicates required question
Nama
*
Your answer
Alamat
*
Your answer
No Telefon
Your answer
No Kad Pengenalan
*
Your answer
Pendapatan Bulanan Keluarga
*
RM1000-RM2000
RM2000-RM3000
Lebih RM3000
Kurang RM1000
Jenis Pekerjaan
*
Berniaga
Swasta
Kakitangan Awam
Tidak bekerja
Alamat Tempat Kerja
Your answer
Adakah anda penerima bantuan Zakat/ JKM?
*
Ya
Tidak
Bilangan Tanggungan
*
Your answer
Jumlah anak bersekolah
Your answer
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