CINTA ABADI Marriage Preparation Form 2019
Course Registration Form
All required information is marked by * Please take note that this course is meant for those who have NEVER been married anywhere before.
Email address *
*Please note that this registration form is for ONE PERSON only. YOUR PARTNER MUST register online separately too.
I am keen to join the MPC course on: *
Tentative / Confirmed Nikah date *
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Name (as in IC / passport) *
Your answer
Identity Card / Passport No. *
Your answer
Date of Birth (dd/mm/yy) *
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Telephone No. (Home)
Your answer
Mobile No. *
Your answer
Address *
Your answer
Postal Code *
Your answer
Citizenship (Please tick) *
Marital Status (Please tick) *
If widow(er) / divorcee, no. of children aged below 21 years (type NIL if inapplicable):
Your answer
Occupation (Please tick) *
Individual Income Level (Please tick) *
Educational Level (Please tick) *
Which type of religious education did you receive? (Please tick) *
Level of religious education (Please tick)
For University Degree in religious education, please indicate Institution attended : *
Your answer
Name of future spouse: *
Your answer
E-mail Address of Future Spouse *
Your answer
Citizenship of Future Spouse (Please tick) *
Marital Status of Future Spouse *
Mode of Payment :PAYMENT METHODS ($140 PER PERSON - full payment to be made within 3 days upon registration. Please note that confirmation of your place in the course is based on our receipt of your full payment). Please make payment to: *
Amount of Payment:S$_____ (There will be no refund. However, you may transfer your place to another couple at least 14 days before the start of course date. Only one postponement date is allowed) *
SELF DECLARATION (ALL COURSE APPLICANTS MUST COMPLETE) *
Required
I found out about MPC programme by Prowise from: *
Required
Special Note: * Certificate will only be given with 100% attendance*
Date of Application *
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Thank you for your registration. We'll send you a confirmation e-mail once we received your payment. Please note that confirmation of your participation will be based on our receipt of your payment.
Your answer
*Note: Class will commence only when we have 4 couples registered. *
A copy of your responses will be emailed to the address you provided.
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