Standard Event Registration Form   活动报名表格

Name(C) 姓名(中) *

Name(E) 姓名(英) [As per IC/Passport] *

Gender 性别 * Please select the gender Male Female

Age 年龄 *

DOB 出生日期 *

NRIC/Passport No. 身份证/护照号码 *

Nationality 国籍

Email 电邮

Tel/HP 电话/手机 *

Fax 传真

Address 地址 *

Previously joined similar Zen Session? 参加过同类禅修营？(Y/N)

Special Physical/Health Condition or Requirements 特殊身心状况/需求

Emergency Contact Person 紧急联络人 *

Relationship with Applicant 关系 *

Tel Contact 联络电话 *

 

Security Code 验证码 *

Name(C) 姓名(中) * Name(E) 姓名(英) [As per IC/Passport] * IC/Passport No 居民证/护照号码 * Tel/HP 电话/手机 *

for non-Malaysian 非大马籍请另注明 Remark

Security Code 验证码 *

Name(C) 姓名(中) *

Name(E) 姓名(英) [As per IC/Passport] *

Gender 性别 * Please select the gender Male Female

Age 年龄 *

DOB 出生日期 *

NRIC/Passport No. 身份证/护照号码 *

Nationality 国籍

Email 电邮

Tel/HP 电话/手机 *

Fax 传真

Address 地址 *

Previously joined similar Zen Session? 参加过同类禅修营？(Y/N)

Special Physical/Health Condition or Requirements 特殊身心状况/需求

Emergency Contact 紧急联络

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For insurance (if any) purposes, the below info must be complete and correct
出于保险(如有)需求，以下资料必须完整与正确

Name of Guardian(as per NRIC/passport)
监护人姓名 (根据身份证/护照)*

NRIC
身份证号码*

Emergency Contact No.
紧急联络电话*

Relationship with Applicant
关系*

Security Code 验证码 *