Private Class-Event Registration
Fill out the form for registration
Name of main Jemaah
*
First Name
Last Name
WhatsApp
Email
Class Gender Type
Please Select
Muslimah ONLY
Mixed Group
Class
Please Select
Private Umrah Class
Private Class-Events (Others)
Class Type
Please Select
Physical Class $250
Online Class $190
Language for Class
*
Please Select
Malay
English
Address for Private Class to be held (For Physical Class only)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date for Class (Please confirm via WhatsApp before input)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
PayNow: UEN 53516519J (HALLA VENTURES)
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