CAWANGAN/ BAHAGIAN/ UNIT ....................................................

JABATAN AGAMA ISLAM NEGERI .................................. /

MAJLIS AGAMA ISLAM NEGERI .................................. /
JABATAN MUFTI ................................

LAPORAN TEMUDUGA
SOKONGAN PAS LAWATAN IKHTISAS
UNTUK TENAGA PENGAJAR WARGANEGARA ASING
(Permohonan Baru/ Lanjutan)

Nama Tenaga Pengajar :

Nombor Pasport :
Tarikh Temuduga :

KENYATAAN
A. LATAR BELAKANG PEMOHON

i. Pemohon adalah warganegara ................................................................................................

ii. Mula memasuki Malaysia pada ................................................................................................
iii. Pemohon menetap di ........................................................................................................
iv. Penganjur .........................................................................................................................

B. PEGANGAN/ALIRAN FAHAMAN/PENGETAHUAN
i. Pemohon bermazhab (fiqh) ........Syafie/Hanafi/Hanbali/Maliki...............................................
ii. Pemohon mempunyai fahaman (akidah)......Ahlus Sunnah Wal Jamaah/Syiah/Lain-lain...........
iii. Pengetahuan Al-Quran :
- Bacaan : .......................
- Tajwid : .........................
- Hafazan : ......................
iv. Pengetahuan As-Sunnah / Hadis : ................................................
v. Pengetahuan Fiqh : ......................................................................
vi. Kemahiran bahasa : ....Bahasa Melayu/Bahasa Arab/Bahasa Inggeris/Bahasa Tamil/Bahasa
Mandarin/Lain-lain............
vii. Shakhsiah pemohon : ...................................

C. AKTIVITI PENGAJARAN
i. Berkhidmat di ...............................................................................................
ii. Mengajar dalam bidang .................................................................................
iii. Berkelulusan ...........PHD/Master/Ijazah Sarjana Muda/Diploma/Sijil/Tiada/Lain-lain................
iv. Bilangan pelajar ...............................................................................................
v. Waktu tempoh mengajar ...................................................................................
vi. Ada/Tidak terlibat dengan sebarang pekerjaan atau aktiviti luar ..........................

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D. PERAKUAN
i. Ada/Tidak menimbulkan sebarang keraguan ......................................................................
ii. Disokong/ tidak disokong....................................................

E. SYOR
i. Sokong : (bulan/tahun)
Ulasan: .............................................................................................
ii. Tidak Sokong :
Ulasan: ..............................................................................................
iii. Lanjutan Terakhir :
Ulasan: ..............................................................................................

F. PANEL PENEMUDUGA JABATAN AGAMA ISLAM NEGERI

Nama : .....................................................
Jawatan : .....................................................

Ulasan Keseluruhan :

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Tandatangan : ................................
Tarikh : ................................