Permohonan Lawatan (Berbakti Bersama)

Permohonan Lawatan/Berbakti Bersama Sila maklumkan ke 0138711250 setelah anda menghantar permohonan
Nama: Pst/Pta/Dkn/Dkns/Bpa/Ibu *
Alamat/SIB *
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Email
Tarikh Cadangan Melawat *	01020304050607080910111213141516171819202122232425262728293031 DD / 010203040506070809101112 MM / 192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030 YYYY 000102030405060708091011121314151617181920212223 HH : 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 MM AMPM AM/PM
Tarikh Keluar *	01020304050607080910111213141516171819202122232425262728293031 DD / 010203040506070809101112 MM / 192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030 YYYY 000102030405060708091011121314151617181920212223 HH : 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 MM AMPM AM/PM
Jumlah Rombongan *
Penginapan Gereja *	Menginap   Tidak Menginap
Tujuan Lawatan *
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