CUSTOMER REFERRAL FORM

PREFERRED CUSTOMER APPLICATION FORM

Fill out the form carefully for registration
BUSINESS CONSULTANT DETAILS

BRANCHBC NAMEBC ACCOUNT NUMBER
CUSTOMER DETAILS

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Phone Number
Format: (000) 000-0000.
LANDLINE
Format: (000) 000-0000.
ID NUMBER
UPLOAD ID

Cancelof
DATA PRIVACY CONSENT FORM
"I understand and do hereby acknowledge that it is necessary to provide the Tupperware Brands Philippines Inc., (""Company"") with my personal data, including my sensitive personal information, for business, commercial and administrative purposes. As such, I agree that the Company may collect and process my personal data and sensitive personal information. I am aware that in the event that the Company needs to share my personal data with third parties, it should inform me and obtain my consent in accordance with R.A. 10173, or the “Data Privacy Act of 2012”. I understand that, through this Consent Form, I am giving my consent to the sharing of my personal data, including my sensitive personal information, with third parties (including, among others, the Company’s Parent company, subsidiaries, affiliates or other related companies). I expressly agree and consent that the Company may collect, record, organize, store, update or modify, retrieve, consult, use, consolidate, block, erase or destroy, or otherwise process, through automated means or manual processing, my personal data, including my sensitive personal information, set out in my application form and/or otherwise provided by me or possessed by the Company in the course of or in connection with my contractual/business relationship with the Company, or the termination or cessation of such contractual/business relationship. I also agree that the Company may inform me of future customer campaigns and offers using the personal information I shared with the company. I hereby acknowledge and warrant that I have acquired the consent from all parties relevant to this consent and hold free and harmless and indemnify the Company from any complaint, suit, or damages which any party may file or claim in relation to my consent.
Date

MonthDayYear
Date
Signature
Should be Empty:

PREFERRED CUSTOMER APPLICATION FORM