An Keahlian Briged Kebajikan Perdana (bkp)

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JABATAN KEBAJIKAN MASYARAKAT MALAYSIA Permohonan Menjadi Ahli Briged Kebajikan Perdana (BKP)

Gambar Berukuran Passport

Butir-butir Permohonan 1. Nama

:____________________________________________________

2. No K/P

:________________________

3. Tarikh Lahir :________________________ 4. Jantina

:

Lelaki

Perempuan

5. Agama

:________________________

6. Taraf Pendidikan: ___________________________________________________ 7. Pekerjaan

:_____________________________________________________

8. Alamat

:_____________________________________________________ _____________________________________________________ _____________________________________________________

9. Telefon

(R): ________________________ (P) : _________________________

10. Email

: ____________________________________________________

11. Kumpulan Sasar yang diminati : a. Kanak-Kanak

d. Keluarga

b. Warga Emas

e. Komuniti

c. Orang Kurang Upaya

f. Mangsa Bencana

12. Bidang Kerja Kemasyarakatan / Kebajikan yang diminati : _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Tandatangan : …………………………..

Tarikh : …………………….

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