Kem Muhibah 2019 Application Form
Date: 13-15 December 2019 (Friday to Sunday)
Registration Time: 4pm, 13 December
End of Camp: 4pm, 15 December
Venue: Sekolah Rendah dan Menengah Islam ABIM Sungai Ramal Lot 1662, Kg. Sg Ramal Dalam, 43000 Kajang, Selangor
Fee: RM50 (food and accommodation)
Eligibility: Form 3 or 4 student in KL or Selangor
Main Organisers: United Chinese School Committees’ Association of Malaysia and Angkatan Belia Islam Malaysia

APPLICATION DEADLINE: 25 NOVEMBER 2019
• This application form can be filled in either English or Bahasa Malaysia. Choosing one or another will not impact your application.
• When you are notified of your successful application for Kem Muhibah (by 30 November), you will receive bank account details to pay the RM50 fee.
• Applicants are also eligible for need-based subsidies to cover your participation fee as well as your transport to and from the camp venue. Please indicate if you need a subsidy in this form.
• Participants will receive an information packet prior to the camp. Please contact Ms Preethika at preethika@aodmalaysia.org or 012-2128424 for any questions.

TARIKH TUTUP PERMOHONAN: 25 NOVEMBER 2019
• Anda boleh menggunakan Bahasa Inggeris or Bahasa Malaysia untuk pengisian borang ini. Pilihan bahasa tidak akan menjejaskan permohonan anda.
• Anda akan menerima butiran akaun bank untuk pembayaran yuran (RM50) dengan keputusan permohonan anda (selewat-lewatnya 30 November).
• Para pemohon juga layak menerima subsidi (mengikut keperluan kewangan) yang menampung yuran dan juga kos pengangkutan ke dan dari kem. Sila nyatakan jika anda memerlukan subsidi.
• Para peserta akan menerima maklumat selanjutnya sebelum kem. Sila hubungi Ms Preethika di preethika@aodmalaysia.org atau 012-2128424 untuk sebarang pertanyaan.
Full name / Name penuh *
Your answer
Gender / Jantina *
Date of Birth / Tarikh Lahir *
MM
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DD
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YYYY
Home Address / Alamat Rumah *
Your answer
IC Number / Nombor IC *
Your answer
Ethnicity / Bangsa *
Phone number / Nombor Telefon *
Your answer
Email / Emel *
Your answer
School / Sekolah *
Your answer
Previous Schools / Sekolah Terdahulu *
Your answer
Languages Spoken / Bahasa-bahasa Ditutur *
Your answer
Medical Conditions or Allergies / Isu Kesihatan atau Alahan *
Your answer
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