Quick Application Form
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Full Name
*
First Name
Last Name (Bin/Binti/a/l/a/p)
Contact Number
*
-
Area Code
Phone Number
Email Address
*
example@example.com
Address
*
Street Address (cth: No. & Jalan)
Street Address Line 2 (cth: Taman, Kampung)
City
State / Province
Postal / Zip Code
Company Address
*
Street Address
Street Address Line 2
Poscode & City
State / Province
Phone Number
Work as?
Pekerjaan
Years of working?
Berapa tahun bekerja
Time Best for you to receive a call?
*
Please Select
10:00A.M - 12:00P.M
12:00P.M - 2:00P.M
2:00P.M - 4:00P.M
4:00P.M - 6:00P.M
Waktu paling sesuai untuk pihak kami buat panggilan kepada anda
Bank
*
contoh: Bank Islam (No. Akaun bank)
Bank Account Number
*
contoh: Bank Islam (No. Akaun bank)
What phone model are you interested in?
*
contoh: iPhone 15 Pro Max 256 boleh ditulis iP15PM 256 sahaja.
Storage
*
Please Select
128GB
256GB
512GB
1TB
Kapasiti mesti ada dalam pilihan atau jika tidak, kami akan memilih storan yang lebih besar/kecil
Tenure
*
Please Select
12 months
24 months
36 months
Berapa bulan yang berminat untuk buat ansuran?
Emergency Contact #1
*
First name
Last name (Bin/Binti/a/l/a/p)
Contact Number for Emergency contact #1
*
-
Area Code
Phone Number
Relationship
*
Please Select
BAPA
IBU
ADIK BERADIK
PASANGAN
Berapa bulan yang berminat untuk buat ansuran?
Emergency Contact #2
*
First name
Last name (Bin/Binti/a/l/a/p)
Contact Number for Emergency contact #2
*
-
Area Code
Phone Number
Relationship
*
Please Select
BAPA
IBU
ADIK BERADIK
PASANGAN
SAUDARA
KENALAN
Berapa bulan yang berminat untuk buat ansuran?
IC Front and Back
*
Browse Files
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Choose a file
Kad Pengenalan jelas dan nampak setiap bucu dan minimum silau cahaya
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of
Payment Slip (Latest)/SSM
*
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Choose a file
Slip gaji terkini. Sekiranya anda berniaga sendiri, sila lampirkan sijil SSM
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of
Bank Statement (Latest)
*
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Penyata bank harus sama seperti butiran bank yang diisi diatas
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of
Statement of EPF/KWSP
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Hanya kepada yang bukan pekerja skim pencen atau berniaga sendiri
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of
Have you applied a loan for smartphone somewhere else before?
*
Yes
No
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