Fracture to Future: Reverts Uniting Malaysia Fracture to Future: Reverts Uniting Malaysia New Muslims Community Conference 2025 Date: 28 August 2025 (Thursday) Time: 9.00 AM - 5.00 PM Venue: The Grand Hyatt, Kuala Lumpur Fee: RM200 per person* RSVP INFORMATIONAre you a Revert?(Required) Yes No Previous Religion(Required) Christian Hindu Buddhist / Taoist / Chinese Folklore Animisme Agnostic Atheist Other Race(Required) Full Name(Required) First Last Gender(Required) Male Female Contact Number(Required)Please include country code (Eg. 60123456789)Email Address(Required)The payment receipt will be sent to this email address. Enter Email Confirm Email Profession(Required) Government Private Self-employed Student Homemaker Retired State(Required)Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaInternational (Outside Malaysia)Country(Required) Number of Attendees(Required)12345Attendee Information #1 Same as RSVP Information Are you a Revert? Same as 'RSVP Information' Previous Religion Same as 'RSVP Information' Phone Number Same as 'RSVP Information' Race Same as 'RSVP Information' Full Name Same as 'RSVP Information' Gender Same as 'RSVP Information' Contact Number Same as 'RSVP Information' Email Address Same as 'RSVP Information' Profession Same as 'RSVP Information' State Same as 'RSVP Information' Country Same as 'RSVP Information'Are you a Revert?(Required) Yes No Previous Religion(Required) Christian Hindu Buddhist / Taoist / Chinese Folklore Animisme Agnostic Atheist Other Race(Required) Full Name(Required) First Last Gender(Required) Male Female Contact Number(Required)Please include country code (Eg. 60123456789)Email(Required) Enter Email Confirm Email Profession(Required) Government Private Self-employed Student Homemaker Retired State(Required)Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaInternational (Outside Malaysia)Country(Required) Attendee Information #2Are you a Revert?(Required) Yes No Previous Religion(Required) Christian Hindu Buddhist / Taoist / Chinese Folklore Animisme Agnostic Atheist Other Race(Required) Full Name(Required) First Last Gender(Required) Male Female Contact Number(Required)Please include country code (Eg. 60123456789)Email(Required)Information related to the Conference will be sent to this email address Same as email above Enter a different email Enter Email(Required) Enter Email Confirm Email Profession(Required) Government Private Self-employed Student Homemaker Retired State(Required)Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaInternational (Outside Malaysia)Country(Required) Attendee Information #3Are you a Revert?(Required) Yes No Previous Religion(Required) Christian Hindu Buddhist / Taoist / Chinese Folklore Animisme Agnostic Atheist Other Race(Required) Full Name(Required) First Last Gender(Required) Male Female Contact Number(Required)Please include country code (Eg. 60123456789)Email(Required)Information related to the Conference will be sent to this email address Same as email above Enter a different email Email(Required) Enter Email Confirm Email Profession(Required) Government Private Self-employed Student Homemaker Retired State(Required)Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaInternational (Outside Malaysia)Country(Required) Attendee Information #4Are you a Revert?(Required) Yes No Previous Religion(Required) Christian Hindu Buddhist / Taoist / Chinese Folklore Animisme Agnostic Atheist Other Race(Required) Full Name(Required) First Last Gender(Required) Male Female Contact Number(Required)Please include country code (Eg. 60123456789)Email(Required)Information related to the Conference will be sent to this email address Same as email above Enter a different email Email(Required) Enter Email Confirm Email Profession(Required) Government Private Self-employed Student Homemaker Retired State(Required)Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaInternational (Outside Malaysia)Country(Required) Attendee Information #5Are you a Revert?(Required) Yes No Previous Religion(Required) Christian Hindu Buddhist / Taoist / Chinese Folklore Animisme Agnostic Atheist Other Race(Required) Full Name(Required) First Last Gender(Required) Male Female Contact Number(Required)Please include country code (Eg. 60123456789)Email(Required)Information related to the Conference will be sent to this email address Same as email above Enter a different email Email(Required) Enter Email Confirm Email Profession(Required) Government Private Self-employed Student Homemaker Retired State(Required)Wilayah Persekutuan Kuala LumpurSelangorJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaInternational (Outside Malaysia)Country(Required) CONFERENCE FEERegistration Fee / Pax Price: Total Payable PAYMENT METHODChoose Payment Method(Required)Online Transfer (FPX)Credit/Debit Card (Visa/Mastercard only)ATM / Direct Transfer Please transfer the total amount to: 5622 6355 7724 AL KHAADEM FOUNDATION (Maybank) Keep the payment slip and upload it below:Upload Proof of Payment(Required) Drop files here or Select files Max. file size: 6 GB. Your placement is only confirmed when PAYMENT IS FULLY PAID. Placement is by first come first serve basis. This is a physical-onsite event. No recording will be provided. For further enquiries, please message via this WhatsApp link (Hilmi Ang): +60122199819 REFUND POLICYThe participant will be eligible for a full refund If he/she withdraws at least ten days prior to the event date. The participant will NOT be eligible for any refund: a. If he/she fails to attend the event b. If he/she withdraws on the event day itself. Refunds may take fourteen days to process after the event date. Notice of withdrawal must be emailed and will be based on the date the email is received by us. Please send your notice of withdrawals emails to [email protected].
