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Borang Wakalah Ibadah Qurban 'Idul Adha' Anjuran KOPUTRA 1440 Hijrah / 2019 Masihi
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1. Maklumat Pemohon
Nama :
*
Your answer
No. Handphone :
*
Your answer
Alamat :
*
Your answer
Email
*
Your answer
Nama Peserta 1 (Satu Bahagian):
Your answer
Sila Tanda A atau B
A - 1 BAHAGIAN LEMBU ( RM 650 - Program Di Malaysia )
B - 1 BAHAGIAN LEMBU ( RM 550 - Program Di Pattani/Narathiwat, Thailand )
Nama Peserta 2 (Satu Bahagian):
Your answer
Sila Tanda A atau B
A - 1 BAHAGIAN LEMBU ( RM 650 - Program Di Malaysia )
B - 1 BAHAGIAN LEMBU ( RM 550 - Program Di Pattani/Narathiwat, Thailand )
Nama Peserta 3 (Satu Bahagian):
Your answer
Sila Tanda A atau B
A - 1 BAHAGIAN LEMBU ( RM 650 - Program Di Malaysia )
B - 1 BAHAGIAN LEMBU ( RM 550 - Program Di Pattani/Narathiwat, Thailand )
Nama Peserta 4 (Satu Bahagian):
Your answer
Sila Tanda A atau B
A - 1 BAHAGIAN LEMBU ( RM 650 - Program Di Malaysia )
B - 1 BAHAGIAN LEMBU ( RM 550 - Program Di Pattani/Narathiwat, Thailand )
Nama Peserta 5 (Satu Bahagian):
Your answer
Sila Tanda A atau B
A - 1 BAHAGIAN LEMBU ( RM 650 - Program Di Malaysia )
B - 1 BAHAGIAN LEMBU ( RM 550 - Program Di Pattani/Narathiwat, Thailand )
Nama Peserta 6 (Satu Bahagian):
Your answer
Sila Tanda A atau B
A - 1 BAHAGIAN LEMBU ( RM 650 - Program Di Malaysia )
B - 1 BAHAGIAN LEMBU ( RM 550 - Program Di Pattani/Narathiwat, Thailand )
Nama Peserta 7 (Satu Bahagian):
Your answer
Sila Tanda A atau B
A - 1 BAHAGIAN LEMBU ( RM 650 - Program Di Malaysia )
B - 1 BAHAGIAN LEMBU ( RM 550 - Program Di Pattani/Narathiwat, Thailand )
*
Dengan ini saya mewakilkan segala urusan qurban dan pengagihannya kepada pihak pengurusan penganjur. Jika sekiranya terdapat lebihan dari baki wang tersebut, saya dengan rela hati bersetuju memberi kebenaran kepada pihak pengurusan penganjur menggunakannya untuk pengurusan qurban atau memasukkan ke dalam akaun masjid / surau yang ditentukan oleh pihak pengurusan penganjur.
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2. Maklumat Bayaran
Sila isi maklumat bayaran bagi yang berkaitan
Tunai (RM) :
Your answer
Cek Atas Nama KOPUTRA (RM & Nama Cek & No.Cek) :
Your answer
Pindahan Akaun KOPUTRA (Koperasi Pelaburan Kakitangan Bank Muamalat Malaysia Berhad) RM :
Your answer
No. Akaun BMMB : 1401 0000 172715 No. Akaun CIMB Bank : 8600254906
3. Perkhidmatan Lain
Aqiqah (RM)
Your answer
Wakaf (RM)
Your answer
Fidyah (RM)
Your answer
Serahan Zakat (RM)
Your answer
No. Akaun BMMB : 1401 0000 172715 No. Akaun CIMB Bank : 8600254906
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