Daftar Ahli/ User Self-Registration
The fields in
*
are required fields
Sila gunakan huruf BESAR
Nama/Name
*
No. Kad Pengenalan/IC
*
Tarikh Lahir/D.O.B
*
Alamat/Address
*
Negeri/State
*
A001 - Ipoh, Perak
A002 - Taiping, Perak
A003 - Perak
B002 - Shah Alam, Selangor
B003 - Kuala Selangor, Selangor
B004 - Rawang, Selangor
BOO1 - Selangor
C001 - Kuantan, Pahang
C002 - Pahang
D001 - Kota Bahru,Kelantan
D002 - Kelantan
J001 - Johor Bahru
J002 - Segamat, Johor
J003 - Johor
K001 - Alor Setar,Kedah
K002 - Kedah
M001 - Melaka
N001 - Seremban,Negeri Sembilan
N002 - Negeri Sembilan
P001 - Georgetown, Pulau Pinang
P002 - Pulau Pinang
R001 - Kangar,Perlis
R002 - Perlis
T001 - Kuala Terengganu
T002 - Terengganu
W001 - Kuala Lumpur
W002 - Putrajaya
X001 - Kota Kinabalu,Sabah
X002 - Sabah
X003 - WP Labuan
Y001 - Kuching, Sarawak
Y002 - SARAWAK
Poskod/PostalCode
*
Alamat Surat-Menyurat sama dengan alamat diatas
Alamat Surat-Menyurat
Negeri Surat-Menyurat
A001 - Ipoh, Perak
A002 - Taiping, Perak
A003 - Perak
B002 - Shah Alam, Selangor
B003 - Kuala Selangor, Selangor
B004 - Rawang, Selangor
BOO1 - Selangor
C001 - Kuantan, Pahang
C002 - Pahang
D001 - Kota Bahru,Kelantan
D002 - Kelantan
J001 - Johor Bahru
J002 - Segamat, Johor
J003 - Johor
K001 - Alor Setar,Kedah
K002 - Kedah
M001 - Melaka
N001 - Seremban,Negeri Sembilan
N002 - Negeri Sembilan
P001 - Georgetown, Pulau Pinang
P002 - Pulau Pinang
R001 - Kangar,Perlis
R002 - Perlis
T001 - Kuala Terengganu
T002 - Terengganu
W001 - Kuala Lumpur
W002 - Putrajaya
X001 - Kota Kinabalu,Sabah
X002 - Sabah
X003 - WP Labuan
Y001 - Kuching, Sarawak
Y002 - SARAWAK
Poskod Surat-Menyurat
Warganegara/Nationality
*
No. H/Phone
*
No. Telefon Rumah
Kaum
C - Chinese
I - Indian
M - Malay
L - Others
Email
*