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Registration No :

Subscription ID:

Subscription Name:

Price:

RM /

Online Banking Details:

Direct Debit Amount:

RM

Repayment Period:

RM
* :
* :
Customer Reference Number
Contact Information:

I fully understand and agree to the Terms & Conditions of Direct Debit services and I acknowledge that upon successful completion of this online application, RM1.00 shall be debited from my selected account to ensure the said account is active for the purpose of application for this service. Please note that at its sole discretion may refund the RM1.00 subject to its own Terms and Conditions.



By proceeding, you agree to authorise to debit the above net charges to your credit/debit card or online banking account.