Borang Keahlian EEMSB

Name:
ID Number
Tarikh Lahir
Address
Sex	Male Female
Race	Malay Chinese Indian Others
Marital Status	Married Single
Jobs	Manager Doctor / Nurse Lecturer Teacher Secretary Clerk Business Police/Army/JPJ/Custom Student Self Working Housewife Others
Sector	Private Government
Telephone (H/P)
Email Address:
1. Saya mengaku bahawa butir-butir berikut adalah benar dan lengkap. 2. Saya bersetuju untuk menjadi pengedar dan akan mematuhi undang-undang dan peraturan Era Edar Marketing Sdn Bhd. 3. Bersama-sama ini disertakan wang sebanyak RM50.00 sebagai yuran keahlian yang tidak boleh dikembalikan.
Payment	MBB BIMB CIMB Paypal (4% charges applied)
When	An hour after i submit this form Within 24 hours after i submit this form Within 24 hours to 48 hours after i submit this form
Please email us ure passport's picture for the member's card processing. Email : Ieja_dina@yahoo.com. Thank you.

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