JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
#JOMJOININSKEN26
BAHAGIAN A: MAKLUMAT DIRI
/ PART A: PERSONAL INFORMATION
(Untuk semua responden) / (For all respondents)
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Nama Penuh (seperti dalam IC)
Full Name (as per IC)
*
Your answer
Race
Kaum
*
Bumiputera
Bukan Bumiputera
Nombor telefon (Contoh: 60123456789)
Phone number (Example: 60123456789)
*
Your answer
Alamat emel
Email address
*
Your answer
Negeri
State
*
Choose
Johor
Kedah
Kelantan
Melaka
Negeri Sembilan
Pahang
Perak
Perlis
Pulau Pinang
Sabah
Sarawak
Selangor
Terengganu
WP Kuala Lumpur
WP Labuan
WP Putrajaya
[Sabah & Sarawak sahaja]
Anda berasal dari zon/bahagian mana?
[Sabah & Sarawak only]
Which zone/part of the state are you from?
*
Choose
Tidak berkenaan / Not related
Sabah - Zon Pantai Barat (Kota Kinabalu, Penampang, Putatan, Tuaran, Papar, Ranau, Kota Belud)
Sabah - Zon Pantai Barat Selatan (Beaufort, Sipitang, Membakut, Kuala Penyu)
Sabah - Zon Utara (Kudat, Kota Marudu, Pitas)
Sabah - Zon Pendalaman (Keningau, Tambunan, Tenom, Nabawan)
Sabah - Zon Sandakan (Sandakan, Kinabatangan, Beluran, Telupid)
Sabah - Zon Tawau (Tawau, Lahad Datu, Semporna, Kunak)
Sarawak - Bahagian Kuching
Sarawak - Bahagian Samarahan
Sarawak - Bahagian Serian
Sarawak - Bahagian Sri Aman
Sarawak - Bahagian Betong
Sarawak - Bahagian Kapit
Sarawak - Bahagian Sibu
Sarawak - Bahagian Mukah
Sarawak - Bahagian Bintulu
Sarawak - Bahagian Miri
Sarawak - Bahagian Limbang
Sarawak - Bahagian Sarikei
Adakah anda kini menjalankan perniagaan?
Are you currently running any businesses?
*
Ya / Yes
Tidak / No
Next
Page 1 of 18
Clear form
Never submit passwords through Google Forms.
This form was created inside of INSKEN.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report