MRCS PENANG STATE TALK- CPR & AED Education in the Japan Community

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MALAYSIAN RED CRESCENT SOCIETY PENANG STATE - REGISTRATION FORM

Date : June 12, 2021
Time : 11.00am - 12.00pm
Online Via Zoom

Full Name (Capital Letters) *

IC Number (with -) *

Email Address *

Contact Number *

I am a *

VAD Member

Adult Member

Other:

Are you PENANG MRCS VAD/Adult Member? *

Yes, I am PENANG VAD/Adult Member

No, I am from Other State

District (if from MRCS PENANG)

State

Island

North Seberang Perai

Central Seberang Perai

South Seberang Perai

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State (if not from MRCS PENANG)

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