Personal Information. Full Name* (As shown on ID Card/Passport): Name to appear on card (maximum 21 CAPITAL letters including spaces)* Nationality*: Gender* Male Female Date of birth* : / / Place of birth*: Number of dependents*: Personal Income Tax Code: ID Card/Passport* Date of Issuance* Place of Issuance*: Foreigner Only Visa number: Visa Expiry Date: / / Permanent residential Address* Current residential address*: Years and months at current address: Year Month Home phone number: Mobile *1 Email*2 Education Level* Secondary High School College University/Master/PhD Marital Status* Single Married Divorce Judicial Separation Others (please specify)
Personal Information. Full Name* (As shown on ID Card/Passport): Name to appear on card (maximum 21 CAPITAL letters including spaces)* Nationality * Date of birth - - Place of birth * Gender * Male Female Number of dependents *: Personal Income Tax Code ID Card/Passport Number * Date of Issuance * Place of Issuance * Foreigner Only Visa number Permanent residential Address * Current residential address * Years and months at current address Home phone number Year Month Mobile *2 E-mail*3 Education Level * Secondary High School College University/Master/PhD Marital Status * Single Married Divorce Judicial Separation Others (please specify) Type of Residential * Self-owned Rented Living with parents Mortgaged Other (please specify) Transportation * Car (self-owned) Motorbike Public Transportation Mother’s maiden name or Primary School’s name* (compulsory for security verification) Number of Complimentary privileges: Option 1: VIP louge - Unlimited, VIP meet: 8 bookings/year, Golf/Spa: 5 bookings/year Option 2: VIP louge - Unlimited, VIP meet: 8 bookings/year, Golf/Spa: 2 bookings/year Option 3: VIP louge – 6 bookings/year, VIP meet: 1 booking/year, Golf/Spa: 1 booking/year 2I/we agree that this mobile is the official number registered with the Bank and used to receive One-time-password (OTP) when doing online transaction (subject to change from time to time through methods stipulated by the Bank). Any Customer's instructions through registered telephone number shall bind upon Customer. 3 Your monthly statement will be sent to registered email above.