agr registration form
TRANSCRIPT
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8/18/2019 Agr Registration Form
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AGR AUTO TRADE SDN BHD
MEMBERSHIP APPLICATION FORM
PLEASE FILL THE FOLLOWING IN CAPITAL LETTERS
Member’s Name Mr/Ms
NRIC No. / Passport No. Gender
/ /
Male Female
Address
City
Mobile
Bank Name Bank Branch
Acc. Payee Name Account No.
Email
StatePostcode
FIRST NAME LAST NAME DATE OF BIRTH
Race Malay Chinese Indian Others If Others
BENEFICIARIES
Tel No.
Ben. Name Relationship
E-mail
BANK INFORMATION
Email: [email protected]
Website: www.agr2u.com
This application constitutes the contractual offer of the undersigned individual(s)/authorized signatories of
the legal entity addressed to AGR Auto Trade Sdn Bhd, to enter into the AGR Biz Partner agreement under
the terms and conditions specified by the company. The applicant hereby certify that they are legally
qualified to do business in Malaysia and not bound by any legal requirement restricting or prohibiting their
appointment as AGR Biz Partner.
PERSONAL INFORMATION
MEMBER’S SIGNATORY
For Office Use Only Mode Of Payment
Cash
Bank Transfer
Ewallet Transfer
1st Copy : AGR | 2nd Copy : Member | 3rd Copy : Account Department
RM
No:
AGR Lot 22B, Jalan 7/2, Taman Serdang Jaya,43300 Seri Kembangan, Selangor Darul EhsanTel: 03-8959 1408 Fax: 03-8959 1409 Email: [email protected] Website: www.agr2u.com
CARTRADE PACKAGESILVER
GOLD
PLATINUM
TITANIUM
MOBILE CENTRE SHOWROOM CENTRE
Member Username
Presenter Username
Registration Date
Upline Username