Borang Permohonan Ahli Stormreaders

Untuk menjadi ahli STORMREADERS sila majukan makluman berikut kepada saya
Yuran Ahli adalah RM90.00


* Name
  Username
* New IC/ Passport No
   Old IC No
* Date of Birth (dd/MM/yyyy)
  Gender
  Marital Status
  Race
  Address
  City
  Postcode
* Country
* State/ Area
  Telephone No (Mobile)
* Email
________________________________________

Benificiary Information
* Name
* IC/ Passport No
* Relationship
* Contact No
___________________________________

Bank Account Information
* Bank
* Branch
* Bank Account Name
* Account No
* Account Type
________________________________________
Account Login Information
 
* Password (6-10 alpha numeric)
* Re-enter Password

e-Wallet Login Information
 
* Password (6-10 alpha numeric)
* Re-enter Password


Emailkan maklumat diatas kepada :
marzaqah@hotmail.com