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PERANCANG HARTA PUSAKA ISLAM
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ISLAMIC ESTATE PLANNER

BORANG PENDAFTARAN KURSUS / TRAINING REGISTRATION FORM

Sila isikan maklumat dalam HURUF BESAR / Please fill the following in BLOCK LETTERS *Sila bawa bersama 1 keping gambar
Sila tandakan  jika perlu / Please tick  if relevant terbaru ukuran passport/Please bring
along latest passport size photograph
Nama penuh / Full Name: _________________________________________________________

No. KP / NRIC No. ___________________________________

Alamat Surat Menyurat/ Correspondence Address

____________________________________________________________________
_______________________________________________________________________________________________________________

No. Tel / Contact No : _______________________ Alamat Email / Email Address: _________________________

Upline/Leader

Cara Pembayaran / Payment Method: Training Date : _________________________

Yuran /Fee:
Lifetime License + Wasiat*
Individual RM1908
Corporate RM3180
*including GST

[ ] Tunai/Cash : RM_________

[ ] Bank-in MAYBANK : 5623 3940 0032 RHB BANK : 2124 3960 0033 71
* sila faks bukti pembayaran / please fax the bank-in slip

[ ] Cek/Cheque: bayar kepada / payable to ‘AS-SALIHIN TRUSTEE BERHAD’

Bank_______________________________ No. Cek / Cheque No. ________________

[ ] Kad Kredit/Credit Card ( Mastercard / Visa )

No. sekuriti / Security no.
No. Kad/Card No.

Tarikh Luput / Expiry Date m m y y

Bank Pengeluar / Issuing Bank : ________________________

_________________________
Tandatangan / Signature
Tarikh / Date :
Sila faks kepada : 03-7880 8190 / No. Tel : 03-78809595 / Email: recruitment@as-salihin.com
Attn:Aziatul Nazmin/Fatin (Kelana Jaya)
: 07-2356993 / No. Tel : 07-2355993 / Email: southern@as-salihin.com
Attn: Irimzan / Rasmin (Johor Bahru)
: 04-3866595 / No. Tel : 04-3909595 / Email: northern@as-salihin.com
Attn: Noraini / Zarul (Seberang Jaya)
* Wasiat is only applicable to Muslim’s IEP / Wasiat percuma hanya untuk IEP Muslim
** Please attach form 24 and 49 to this registration form (Corporate) / Sila sertakan borang 24 dan 49 pada borang permohonan ini (Korporat)
2015© Borang Pendaftaran Kursus
 TRAINING DATES FOR YEAR 2015
Kelana Jaya: 101 & 201, Block A, Glomac Business Centre, No. 10, Jalan SS6/1, Kelana Jaya,
47301 Petaling Jaya, Selangor
Seberang Jaya : No. 32A, Jalan Todak 2, Bandar Sunway, 13700 Seberang Jaya, Pulau Pinang.
Johor Bahru: No. 9-01, Jalan Setia Tropika 1/30, Taman Setia Tropika, Kempas,
81200 Johor Bahru, Johor.

Date
Product Training
MONTH AMLA & Marketing BOP
Weekday Weekend Training @4pm
(Mon-Tue) (Sat – Sun) (Mon)
9 am – 5 pm 9 am – 5 pm

January 5-6 17 – 18 19 7

February 9 - 10 14 – 15 16 7

March 9 - 10 21 – 22 23 4

April 6-7 25 - 26 27 1

May 11 - 12 23 – 24 25 6

June 8-9 27 – 28 29 3

July 6-7 25 – 26 27 1

August 3 -4 22 - 23 24 5

September 7-8 19 – 20 21 2

October 5-6 24 - 25 26 7

November 2-3 21 - 22 23 4

December 7–8 19 – 20 21 2