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IPC Online Application
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Section A: Personal Particulars
–
Step
1
of 4
Name (as in NRIC/Passport)
*
NRIC/Passport No (last 4 digits)
*
Gender
*
M
F
Nationality
*
Religion
*
Duration in Singapore (if not residing in Singapore)
Contact Number
*
Email
*
Next
Reasons for IPC Request
*
General availability
*
Preferred Languge
*
English
Mandarin
Tamil
Malay
Others
Next
I agree that I will use the information given to me about the IPC Teacher in confidence and solely for the purpose of arranging for IPC sessions only. I understand that any form of misuse may lead to the cancellation of my IPC sessions and that I will be in breach of the Personal Data Protection Act (PDPA). I also agree that collective consents have been obtained allowing Muslim Converts’ Association of Singapore to collect, use, process and disclose the personal data in in accordance to the terms and conditions as stated in the Muslim Converts’ Association of Singapore Personal Data Protection Policy (available on the website).
Signature (Applicant)
*
Clear Signature
Next
IPC Request
Approved
Not Approved
IPC Teacher's Name
Name (Requesting Officer)
Signature (Requesting Officer)
Clear Signature
HOD Endorsement
Signature (HOD)
Clear Signature
Submit Entry
0
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