Online Student Registration Form - Maahad Tahfiz Negeri Pahang
A. REGISTRATION INFORMATION
PROGRAM*
FOR INTAKE YEAR*
FOR LEVEL FORM/YEAR*
PREFERRED SESSION* Preferred Session Will Be Finalized By Management
PREVIOUS SCHOOL
B. STUDENT INFORMATION
Student Name*
Citizen
IC No/Passport* (No Space and Dash '-')
Birth Cert. No
Birth Place*
Birth Date*
Gender/Race/Religion*
Tel. Mobile* (Parent) (No Space and Dash '-')
Email (Parent)
Eg. mel@yahoo.com
Tel. Home
Home Address (Line 1)*
Home Address (Line 2)
City*
Postcode*
*District (PAHANG Sahaja)
Illness/Alergic

 Others (Specify)
 
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C. FATHER INFORMATION
Name*
IC No*
Birth Place*
Occupation*
Salary* (RM)
Pendidikan Tertinggi
Employer*
Address
Tel. Mobile* (No Space and Dash '-')
Tel. Home
Tel. Office Fax:
Email
Eg. mel@yahoo.com
D. MOTHER INFORMATION
Name*
IC No*
Birth Place*
Occupation* House Wife (Click)
Salary* (RM)
Pendidikan Tertinggi
Employer
Address
Tel. Mobile* (No Space and Dash '-')
Tel. Home
Tel. Office Fax :
Email
Eg. mel@yahoo.com
E. FAMILY INFORMATION
  Name School/College/Job Birth Year
1.
2.
3.
4.
5.
6.
7.
8.
F. FOR EMERGENCY CONTACT (Beside Parent)
 Name*
 Relation*
 Tel. Mobile* (No Space and Dash '-')
 Tel. Home
 Tel. Office
 Fax
 Email
Eg. mel@yahoo.com
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G. MAKLUMAT AKADEMIK
1. MAKLUMAT PEPERIKSAAN PERCUBAAN SPM
(Sila tandakan subjek yang berkenaan sahaja)
NAMA SEKOLAH*
TAHUN PEPERIKSAAN*
BAHASA MALAYSIA
BAHASA INGGERIS
SEJARAH
MATEMATIK
PENDIDIKAN ISLAM
MATEMATIK TAMBAHAN
FIZIK
KIMIA
BIOLOGI
BAHASA ARAB TINGGI
AL QURAN DAN AL SUNNAH
SYARIAH ISLAMIAH
2. PEPERIKSAAN LAIN (Jika ada. Contoh: PMR / SMA)
Nama Sekolah
Tahun
Nama Peperiksaan
  Mata Pelajaran Gred/Keputusan
1
2
3
4
5
6
7
8
9
10
3. MAKLUMAT KOKURIKULUM
  Sukan/Kelab/Persatuan Jawatan Tahap Sekolah/Daerah/Negeri/Negara
1
2
3
4
5
4. PENGUASAAN AL-QURAN
Kelancaran Membaca Quran Baik   Sederhana   Lemah
Kemahiran Membaca Jawi Baik   Sederhana   Lemah
Kemahiran Menulis Jawi Baik   Sederhana   Lemah
Telah Khatam Quran Ya   Tidak.
Jika TIDAK, juzuk ke berapakah sekarang?
Pernah Hafaz Quran Ya   Tidak.
Jika YA, Brapa juzukkah yang telah dihafal?

I, here with agreed that all information given is correct. Maahad Tahfiz Negeri Pahang has the rights to reject without prior notice. Thank you.