SYARIKAT BERJAYA GLASSWARE SDN.BHD.
NAMA PENUH / FULL NAME *
NO KAD PENGENALAN / ID NO. *
TARIKH LAHIR / DATE OF BIRTH *

MM		/
DD		/
YYYY
ALAMAT PENUH / FULL ADDRESS *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
NO TELEFONE / TELEPHONE NO. *
NO TELEFONE MUDAH ALIH /MOBILE PHONE NO. *

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ALAMAT PERNIAGAAN / BUSINESS ADDRESS *
TEMPAT URUSAN /MANAGE PLACE
PENGALAMAN BERNIAGA / BUSINESS EXPERICE *
MODAL / CAPITAL
PENGALAMAN DALAM JUALAN LANGSUNG(TAHUN) / BUSINESS EXPERIENCE (YEAR)
TELAH MENJADI STOKIS UNTUK SYARIKAT / HAD BEEN STOCKIEST FOR COMPANY
BILANGAN PELANGGAN / CUSTOMER COUNT.
MAKLUMAT STOKIS PENAJA(JIKA ADA) /SUB-STOCKIEST INFO (IF HAVE)

NAMA / NAME:
KOD /CODE:
ALAMAT / ADDRESS:

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