Youth Form

ALMAWADDAH MOSQUE VOLUNTEER DETAIL

Please paste your photograph here

PERSONAL PARTICULARS (Mosque Youth Wing) *Name: *NRIC No.: Gender: *Date of Birth: Marital Status: *Employment Status: Work Permit:

Female / Male

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/

Single / Married / Widowed / Divorced Full-time / Part-time / Contract Yes / No

If Yes, Work Permit No: *Home Address: *Blk/Street: *Unit: *Postal Code: *Home Tel: Pager No: Handphone No: *Email Address:

________________________________________

*Occupation: *Mosque Attached To: *Date of Employment: Current Monthly Income: *Highest Level of Education Attained:

Language Proficiency:

Nationality:

Type of Dwelling:

Hobbies/Interest: National Service Liability:

/    

/ $500 and below $501 to $1000 $1001 to $2000 Above $2000

___________________________________      

English Malay Tamil Mandarin Arabic/Jawi Others, Please Specify: ________________

Singaporean / PR / Foreigner         

HDB 1-room HDB 2-room HDB 3-room HDB 4-room HDB 5-room HDB Executive HUDC Bungalow Condominium"

_________________________________________________________ Served / Exempted

* Required fields Course / Training / Seminar Course Title:

__________________________________________________________

Organised by:

__________________________________________________________

/ /

Date from: Date to: Remarks:

/ /

__________________________________________________________

Family Particulars (Parents/Spouse) Name: Nric No: Occupation: Contact No: Relationship:

__________________________________________________________ ______________________

Are you interested in joining our Executive Committee?

Are you interested in joining any event planning?

As a youth volunteer you will also be asked to assist in some areas of your interest, please tick the appropriate boxes below to indicate any skills or interests, you may tick more than one: EVENTS

INTERESTS

SKILLS

Camps

Outdoors

IT

Talks, forums & workshop

Sports

Designs/Artworks

Religious ceremonies

Information Technology

Oratory

Others, please specify

Movies

Language, specify _________________

Games

Others, please specify

_________________________

Music / Instruments

______________________________

Traveling Photography

LIABILITY RELEASE AND INDEMNITY

I hereby fully release and discharge the Almawaddah Mosque Youth Engagement Unit, including its Board of Management unconditionally from any and all claims and liabilities whatsoever arising from my voluntary participation in any of the activities of the organisation, including any and all incidental activities related to it. Accordingly I unconditionally convey risk of all actions, claims, costs, damages, expenses, judgments, liabilities, suits and reasonable attorneys fees, arising out of my participation in any of the organisation's sponsored events, including but not limited to any negligence or alleged negligence by the organisation or any service provider it retains. In reference hereto, I hereby unconditionally waive and release any and all present or future claims of costs, damages, expenses, liabilities and suits against the Released Parties, and I hereby agree to defend, indemnify and hold the Released Parties harmless from and against any and all such claims, costs, damages, expenses, liabilities and suits, including all attorney’s fees, medical expenses, monetary damages and any other claims which may arise as a consequence of my participation in the activities of the organisation.

Signature:

Date:

Parent/ Guardian Signature*:

Date:

*Parent or guardian's signature is needed for applicant below the age of 18.

Al-Mawaddah Mosque | Sengkang Central Post Office P.O Box 861 S 915408 | Email: [email protected]/ Fax: 63840403

Note: If there is insufficient space, please use and attach additional sheets of papers to this form.