Member Signup Form
Sponsor Information
*
Sponsor Code
:
Placement Information
*
Placement Code
:
Account Information
*
Member Name
:
*
IC No.
:
*
IC Type
:
-- SELECT --
New IC
Old IC
Business Registeration
Others
Gender
:
Male
Female
Date of Birth
:
2004
2003
2002
2001
2000
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Race
:
MALAY
CHINESE
INDIAN
OTHERS
Occupation
:
*
Address
:
:
City
:
State
:
SELECT
JOHOR
KEDAH
KELANTAN
KUALA LUMPUR
LABUAN
MELAKA
NEGERI SEMBILAN
PAHANG
PERAK
PERLIS
PULAU PENANG
PUTRAJAYA
SABAH
SARAWAK
SELANGOR
TERENGGANU
PostCode
:
Country
:
EAST MALAYSIA
INDONESIA
THAILAND
WEST MALAYSIA
Home Phone No
:
Mobile Phone No
:
Office Phone No
:
Fax Phone No
:
Preferred Language
:
-- SELECT --
ENGLISH
MALAY
CHINESE
Spouse Information
Marital Status
:
SINGLE
MARRIED
Spouse Name
:
Spouse IC/Passport No
:
Spouse Relationship
:
Bank Account Information
Bank
:
SELECT BANK
Alliance Bank
Ambank
Bumiputra-Commerce Bank Berhad
Bank Islam Malaysia Berhad
Bank Rakyat
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CIMB
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EON Bank
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Maybank
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Public Bank
RHB Bank
Southern Bank
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Affin Bank/Affin Islamic Bank
Bank Branch
:
Account No
:
*
You cannot change the Bank Payee Name after you have registered, please make sure that your Bank Payee Name is correct.