"GREEN HELPERS” REGISTRATION FORM
BORANG PENDAFTARAN “SUKARELAWAN HIJAU"

We are looking for Green Helpers (above 18 years old) who are interested in making our living environment greener, cleaner and more sustainable. Join us to explore how we can protect, preserve and promote the environment as an individual / in a group. Together we can achieve our vision and mission.

Personal Detail
Maklumat Peribadi




Plan to register in a group?
Merancang untuk mendaftar dalam kumpulan?


If you are the person-in-charge for a school/ company or any other organisation who wish to register your fellow students/ staff with our volunteering programs, you may download our group registration forms. Complete the form and email back to us ([email protected]) with subject title: [Green Helpers Group Registration/ Your Organisation's name]. We will get in touch with you once your group registration form is received.

Jika anda adalah orang yang bertanggungjawab bagi sekolah / syarikat atau mana-mana organisasi lain yang ingin mendaftarkan kumpulan pelajar / staf anda dengan program-program sukarela kami, anda boleh memuat turun borang pendaftaran kumpulan kami. Lengkapkan borang tersebut dan emel kembali kepada kami ([email protected]) dengan tajuk perkara: [Pendaftaran Sukarelawan secara Kumpulan/ Nama Organisasi anda]. Kami akan menghubungi anda sebaik sahaja borang pendaftaran kumpulan anda diterima.
1 Name:
Nama:

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2 IC Number:
Nombor Kad Pengenalan:

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3 Gender:
Jantina:

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4 Occupation:
Pekerjaan:

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5 Addres:
Alamat
s:




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6 Contact Number:
Nombor Telefon:

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7 Email:
Emel:

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8 What are the environmental issues you are interested in?
Antara isu-isu alam sekitar yang berikut, yang manakah yang anda minati?

 




Please make a selection. Please make at least one selection. Maximum number of selections exceeded.
9 You would like to become a:
Anda memilih untuk menjadi seorang:
 
(b) Event Volunteers? / Sukarelawan Untuk Majlis/Acara/Aktiviti Lain

Please make a selection.
If you choose (a), proceed to Q10; choose (b) proceed to Q11
Sekiranya anda pilih (a), sila teruskan ke Soalan 10; kalau pilih (b), teruskan ke Soalan 11
10 What are the programs/ projects you are able to help?
Anda boleh membantu kami mengendalikan mana satu program/ projek berikut?
 
House to House Campaign / Kempen Rumah ke Rumah
Other Community-Based Activities / Aktiviti Berasaskan Komuniti


Please make a selection. Please make at least one selection. Maximum number of selections exceeded.
11 In what way you can contribute in our events?
Bagaimana anda boleh membantu dalam majlis/acara/aktiviti kita?
 
Master of Ceremony / Pengacara Majlis
(Language(s) / Bahasa )

Design for Publicity Materials / Rekacipta Bahan Publisiti
Recycling Art/Craft (eg: making enzyme) / Seni Kitar Semula
Photography / Fotografi
Videography / Videografi
Translation / Penterjemahan
(Please specify: from / Sila nyatakan: dari bahasa to/ ke )
Conference and Seminar / Persidangan dan Seminar
Exhibition / Pameran
Others / Lain-lain
Please make a selection. Please make at least one selection. Maximum number of selections exceeded.
12 Days available:
Hari yang anda boleh membantu kami:
 




Please make a selection.
Personal Data Protection Statement

"I hereby declare that all the information provided below is true and correct to the best of my knowledge. I agree to these personal data being processed for volunteer purposes and I will be receiving updated information of all programmes and projects by PGC Strategies Sdn Bhd (Penang Green Council) in accordance with Personal Data Protection Act 2010.

I agree to abide by all rules and regulations set by Penang Green Council's Green Helpers Program and I am fully aware that Penang Green Council's Green Helpers Program has the right to reject or suspend my registration should there be any false information provided in this application form."



You must agree before you can submit.
 
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