borang pengurusan jenazah_siri2
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MASJID TUANKU MIZAN ZAINAL ABIDIN JABATAN KEMAJUAN ISLAM MALAYSIA
PRESINT 3,63500 PUTRAJAYA Tel :03-8880 4300 Fax : 03-8890 1614
LAMAN WEB : www.masjidtuankumizan.gov.my EMEL : admin@masjidtuankumizan.gov.my
BORANG PENDAFTARAN
PROGRAM/KURSUS/SEMINAR : KURSUS PENGURUSAN JENAZAH SIRI 2
TARIKH : 26 -27 OKTOBER 2013 (SABTU – AHAD)
MASA : 8.00 PAGI – 5.00 PETANG
Nama
No.Kad Pengenalan
Alamat/Jabatan/Agensi : ______________________________________________________
______________________________________________________
______________________________________________________
No. Tel : _____________________(P) ____________________(H/P)
E-mail : ______________________________________________________
Tandatangan Tarikh :
………………………………………… ( )
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