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BORANG MAKLUMBALAS KURSUS PSH KOLEJ KOMUNITI HULU SELANGOR
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BORANG 7: BORANG MAKLUMAT PESERTA
NAMA
*
Your answer
NO KAD PENGENALAN
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Your answer
TARIKH LAHIR
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MM
/
DD
/
YYYY
ALAMAT SURAT-MENYURAT
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Your answer
NO TELEFON BIMBIT
*
Your answer
EMAIL
*
Your answer
BANGSA
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MELAYU
CINA
INDIA
BUMIPUTERA SARAWAK
BUMIPUTERA SABAH
ORANG ASLI
TARAF PENDIDIKAN
*
DARJAH 6
SRP/PMR
SPM
STPM
SIJIL KOLEJ
SIJIL POLITEKNIK
DIPLOMA
IJAZAH/SARJANA MUDA
MASTER/SARJANA
PHD
LAIN-LAIN
PENDAPATAN (BULANAN)
*
KURANG DARI RM1000
RM1001 -RM2000
RM2001 - RM3000
RM3001 - RM4000
RM4001 - RM5000
RM5001 - RM10,000
LEBIH DARI RM10,000
TIADA PENDAPATAN
PEKERJAAN
*
Your answer
STATUS PERKAHWINAN
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BUJANG
BERKAHWIN
DUDA
JANDA/BALU
KECACATAN/KETIDAKUPAYAAN
*
TIADA
PENGLIHATAN
FIZIKAL
PERCAKAPAN
PENDENGARAN
LAIN-LAIN
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