Registration Form - Projek Suara

Step 1 of 5 - PART 1: PERSONAL INFORMATION / BAHAGIAN 1: MAKLUMAT PERIBADI

Name/Nama(Required)

Age/Umur(Required)

Please enter a number from 16 to 30.

Gender/Jantina(Required)

Date of Birth/ Tarikh Lahir (DD/MM/YYY)(Required)

IC Number/ Nombor IC(Required)

Email/E-mel(Required)

Contact Number/Nombor Telefon(Required)

Ethnicity/Etnik(Required)

Religion/Agama(Required)

Permanent Address/Alamat Tetap(Required)

Postcode/Poskod(Required)

Division/Bahagian(Required)

District/Daerah(Required)

Medication Allergies/Alahan Ubat(Required)

No/Tidak

Yes/Ya

Do you have any of the following health requirements/complications? Adakah anda mempunyai keperluan/komplikasi kesihatan berikut?

Please explain/Sila jelaskan(Required)

Do you have any health complications/diseases that need to be considered? Adakah anda mempunyai komplikasi kesihatan/penyakit yang memerlukan perhatian?(Required)

No/Tidak

Yes/Ya

Please explain/Sila jelaskan(Required)

Are you fully vaccinated with two doses? Adakah anda sudah lengkap vaksin dua dos?(Required)

No/Tidak

Yes/Ya

Name/Nama(Required)

Telephone No./No. Telefon(Required)

Relationship/Hubungan(Required)

Address/Alamat(Required)

Food Allergies/Alahan Makanan(Required)

No/Tidak

Yes/Ya

All food served throughout the event is halal guaranteed. Semua makanan yang disajikan sepanjang acara dijamin halal.

Please explain/Sila jelaskan(Required)

Do you have any dietary requirements/restrictions?(Required)

None

Vegetarian

Vegan

Other

Please provide us with your thoughts on “How can we enhance the unity in Sarawak in a Post COVID-19 world?” / Sila nyatakan pendapat anda tentang “Bagaimanakah akan kita mengeratkan perpaduan di Sarawak dalam dunia pasca COVID-19?” / (minimum: 50 words / 50 patah perkataan)(Required)

You may include the following items: Anda boleh sertakan isu-isu berikut: -Digital Transformation / Transformasi digital -Shared vision and identity / Visi dan identiti bersama -Socio-economic development / Pembangunan sosio-ekonomi -Intergenerational understanding / Persefahaman antara generasi -Youth political participation and activation / Penyertaan dan pengaktifan politik belia -Religious harmony / Keharmonian agama

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Phone

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Registration Form / Borang Pendaftaran