SCHEDULE (RELIGIOUS TEACHING AND LECTURING SUPERVISORY REGULATIONS 2013

Pk. P.U. 10/2013
RELIGIOUS TEACHING AND LECTURING SUPERVISORY REGULATIONS 2013

SCHEDULE

RELIGIOUS TEACHING AND LECTURING SUPERVISORY

REGULATIONS 2013

FORM TM I

MAJLIS AGAMA ISLAM DAN ‘ADAT MELAYU PERAK APPLICATION FOR TEACHING TAULIAH
[regulation 3]

To

Pengerusi Jawatankuasa Pengawasan Pengajaran Agama Islam
Negeri Perak Darul Ridzuan
Tkt. 5, Kompleks Islam
Jalan Panglima Bukit GantangWahab
30000 Ipoh

Kindly be informed that I wish to apply for Teaching Tauliah in the State of Perak and my particulars are as follows:

Full Name : ........................................................................................................................................................................................

NRIC:....................................................................................................................................................................................................

*Passport No. and expiry date: .......................................................................................................................................................

*Visa No. and expiry date: ................................................................................................................................................................

* Professional Pass No. and expiry date: .....................................................................................................................................

Address: ..............................................................................................................................................................................................

Tel. No.: ................................................................................................................................................................................................

Date of Birth: ........................................................................................................................................................................................

Place of Birth: ......................................................................................................................................................................................

Qualification/Place: ............................................................................................................................................................................

Knowledge/field studied: ..................................................................................................................................................................

Name of Teacher: ................................................................................................................................................................................

Degree/Qualification/Certificate/Syahadah/
Letter of acknowledgement: ..............................................................................................................................................................

Subject/field applied to teach: ...........................................................................................................................................................

Place proposed to teach: ....................................................................................................................................................................

Experience: ...........................................................................................................................................................................................

I hereby declare that all the particulars above are true.

Applicant Signature: ..................................................................................................... Date: ................................................................
* To be filled by applicant who is non-citizen.
Comment by District Religious Administrative Officer:

Signature: ...................................................................................................................... Date: .....................................................................

For Office Use:

Application form received on ........................................................................................................................................................................
Application approved/rejected (reason if any) :
.............................................................................................................................................................................................................................
.............................................................................................................................................................................................................................
............................................................................................................................................................................................................................
Written/oral test on..........................................................................................................................................................................................
Place: ................................................................................................................................................................................................................

Result: PASS/FAIL

RELIGIOUS TEACHING AND LECTURING SUPERVISORY REGULATIONS 2013

FORM TM II

MAJLIS AGAMA ISLAM DAN ‘ADAT MELAYU PERAK TREACHING TAULIAH
[regulation 6]

Whereas the Majlis Agama Islam dan ‘Adat Melayu Perak hereby award this Tauliah to. ................................................................................................. NRIC/Passport No. ......................................................... address .................................................................................................................................................................................................... to teach the Religion of Islam in the State of Perak Darul Ridzuan.

May Allah shower upon you to divine guidance and direction for the divinity and greatness of Islam in this state. May Allah Bless you.

Date: .......................................................................
Hijrah: .....................................................................

President,
Majlis Agama Islam dan ‘Adat Melayu
Perak Darul Ridzuan

RELIGIOUS TEACHING AND LECTURING SUPERVISORY REGULATIONS 2013

FORM S I

MAJLIS AGAMA ISLAM DAN ‘ADAT MELAYU PERAK APPLICATION FOR APPROVAL TO ORGANISE AND
DELIVERING RELIGIOUS LECTURES
[regulations 11 and 17]

Religious Administrative Officer,
District of .............................................

Sir,

I/We wish to apply the permission to organise/deliver a religious lectures and the particulars pertaining to it are as follows:

1. *Name of organiser: ...................................................................................................................................................................................

2. Name of officer responsible:. ..................................................................................................................................................................

3. Address: .......................................................................................................................................................................................................

4. Place of Lecture: ........................................................................................................................................................................................

5. Topic of Lecture: .........................................................................................................................................................................................

6. Purpose of Lecture: .....................................................................................................................................................................................

7. Date of Lecture: ............................................................................................................................................................................................

8. Details of Speaker:

i. Name: ........................................................................................................................................................................................................

ii. Address & NRIC: ......................................................................................................................................................................................

**Passport No. and expiry date: ........................................................................................................................................................

**Visa No. and expiry date: ..................................................................................................................................................................

**Professional Pass No. and expiry date: ........................................................................................................................................

iii. Qualification: ................................................................................................................................................................................................

iv. Occupation: ..................................................................................................................................................................................................

v. Experience: ....................................................................................................................................................................................................

I solemnly declare and agree that I shall be responsible to uphold and honour the Administration of the Religion of Islam (Perak) Enactment 2004 and the Religious Teaching and Lecturing Supervisory Regulations 2013 and will do my utmost best to ensure the session of which I have been permitted to conduct, will run smoothly and effectively as it should be in the name of Religion of Islam.

Date:...................................................

Signature of Applicant (Organiser) and Official stamp

.......................................................................

Signature of Applicant (Speaker)

......................................................................

* If the organiser is an association or a body, besides just name of the association or the body, the person responsible for the association or the body is required to sign the application form as the applicant (organiser).

**To be filled by applicant who is non-citizen.

RELIGIOUS TEACHING AND LECTURING SUPERVISORY REGULATIONS 2013

FORM S II

MAJLIS AGAMA ISLAM DAN ‘ADAT MELAYU PERAK PERMISSION TO ORGANISER OR TO DELIVER RELIGIOUS LECTURES
[regulations 11 and 17]

1. Whereas

(Name) ................................................................................................................................................................................................................................................
NRIC ....................................................................................................................................................................................................................................................
Address ..............................................................................................................................................................................................................................................
...............................................................................................................................................................................................................................................................
................................................................................................................................................................................................................................................................
have been given permission to organise/deliver a religious lectures on/from ....................... day .................. year ............. until .............. day ...............
year ........................... time .............................. until ...............................

2. The Speaker is:

Name: .........................................................................................................................................................................................................................................................
Address: ....................................................................................................................................................................................................................................................
NRIC:...........................................................................................................................................................................................................................................................
Proffession: ...............................................................................................................................................................................................................................................
Place ofWork: ............................................................................................................................................................................................................................................

Tauliah or other authority (if any):
......................................................................................................................................................................................................................................................................
.....................................................................................................................................................................................................................................................................

May your goodselves carry out the task entrusted on you as envisaged by Islamic teachings.

Date: .............................................

Religion Administrative Officer
District of ..............................................
................................................................

Enacted 14 December 2012
[MAIAMP(BP) A603/666/1 Jld. 2; PU.PK. 17/2007]

By His Royal Highness’s Command,

Dato’ Seri Diraja Dr. Zambry Bin Abdul Kadir
Menteri Besar
Perak Darul Ridzuan