Khidmat Sign Up Form:
Ahlan Wa Sahlan! Kindly reserve your interest and our office will revert you as soon as possible. Syukran
Full Name
*
First Name
Last Name
E-mail
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Number
*
Service Package :
*
Badal Umrah : S$550
Package A : S$2,200 (Badal Haji, Korban & Khatamal Quran
Package B : S$1,650 (Badal Haji & Korban)
Badal Haji : S$1,450
Khatamal Quran : S$550
Aqiqah : S$350
Korban : S$350
No. Of persons (intended for Kiriman)
*
Recommended by : (Kindly state name of referral if any)
Nama-nama pengirim (keluarga/waris)
Name for Kiriman (Arwah)
*
Photo of person Intended for kiriman :
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Appointment (Optional)
Number of Visitors
Kindly bring the following upon registration :
Name of Sender (Waris)
Name of Applicant
Photo of intent person
Full payment by Cash, Cheque or PayNow
Submit
Additional Info
Name of Sender requested their additional info for address & contact number to reach. Photo of kiriman will be used for certification. PayNow can be made via UEN once we have sent the invoice
Should be Empty: