Application Form

1

Name

2

NRIC No

3

Phone No

4

E-mail

5

Post Code

6

Address

7

Payment choice

		Monthly
		4-time installment
		2-time installment
		Single payment

8

Payment method

		Cash
		Cheque
		Money transfer

9

If paid by cheque, cheque No

10

inquiry

Thank you for your inquiry.

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