MALAYSIA INDIAR BUSINESS OWNERS

G.P.O.BOX No : 13030, KUALA LUMPUR
50796 MALAYSIA

Email : mibo247@yahoo.com

Application Form

Details
Full Name:
Commercial Name:
Father  Name:
Mother Name:
Mother Tongue:
Race:		Tamilian Non Tamilian Specify)
Religion:
Hight:
Weight:
Marital Status:
Education:
Date of Birth:		JanFebMacAprMayJuneJulAugSeptOctNovDec
Place of Birth:
Age:
Sex:
MyCard  No:
Address(H):
Address(O):
Hobby:
Ambition:
Spoken Language:
Written Language:
Working Destination:
Contect No:
E-Mail:

Company / Holdings / Trustee / Foundation :-
Company Name:
Company Reg.Number
Company Address:
Nature of Business:

I HEREBY AGREE AND ABIDE TO THE RULES & REGULATIONS OF MALAYSIA INDIAR BUSINESS OWNERS

_________________________________        ________________________________ 

Signature                            Date  

Note: Pls Print Out This Form & Fill Up Post to Above MIBO Address.