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  • DXN Marketing Sdn. BHD.: Distributor Application Form

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    Ariel
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    This document is a distributor application form for DXN Marketing Sdn. Bhd. The form requests personal information such as name, identification numbers, contact details, and banking information. It also asks if the applicant or their spouse has previously registered as a member. The applicant must declare that the information provided is correct and agree to abide by the company's rules and regulations. Upon approval, the applicant will become a valid distributor.

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    Original Title

    Member Application En

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    This document is a distributor application form for DXN Marketing Sdn. Bhd. The form requests personal information such as name, identification numbers, contact details, and banking information. It also asks if the applicant or their spouse has previously registered as a member. The applicant must declare that the information provided is correct and agree to abide by the company's rules and regulations. Upon approval, the applicant will become a valid distributor.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    83 views1 page

    DXN Marketing Sdn. BHD.: Distributor Application Form

    Uploaded by

    Ariel
    This document is a distributor application form for DXN Marketing Sdn. Bhd. The form requests personal information such as name, identification numbers, contact details, and banking information. It also asks if the applicant or their spouse has previously registered as a member. The applicant must declare that the information provided is correct and agree to abide by the company's rules and regulations. Upon approval, the applicant will become a valid distributor.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 1

    DISTRIBUTOR APPLICATION FORM

    DXN MARKETING SDN. BHD. (283904-P)


    WISMA DXN, 213, LEBUHRAYA SULTAN ABDUL HALIM, 05400 ALOR SETAR, KEDAH DARULAMAN, MALAYSIA.
    TEL: 6-04-7720277 FAX: 6-04-7723767

    Notice : Please read DXN Rules and Regulations before completing this form. Fill in the fields what is marked with asterisk!

    APPLICANT'S PARTICULAR
    NAME:*

    MOTHER`S MAIDEN NAME:*

    I/C NO.: * MALE FEMALE

    PASSPORT NO.: DATE OF BIRTH:*

    ADDRESS:*

    POST CODE:* STATE:* COUNTRY:*

    TEL NO. RES:* MOBIL:

    EMAIL ADDRESS:*

    BANK ACCOUNT NUMBER:

    BANK ACCOUNT OWNER:

    SPOUSE'S PARTICULAR
    NAME:

    I/C NO: * MALE FEMALE

    PASSPORT NO.: DATE OF BIRTH:

    Have you or your spouse registered before as a member? YES NO Previous Code No.:

    BENEFICIARY'S PARTICULAR
    NAME:

    MOTHER`S MAIDEN NAME:

    I/C NO: * MALE FEMALE

    PASSPORT NO.: RELATIONSHIP:

    SPONSOR'S PARTICULAR
    NAME:

    SPONSOR'S CODE:

    APPLICANT'S DECLARATION AND SIGNATURE


    1. I declare that all details given are correct. Should there be any false information given, the company reserves the right to terminate this application without prior
    notice.
    2. I confirm that my spouse and I have not been active for the past 12 consecutive months or my spouse and I have never joined DXN at the time of this application.
    3. I understand that I will be a valid DXN distributor upon approval of this application.
    4. I have read and agreed with all Rules and Regulations of the company.

    FOR OFFICE USE ONLY


    DATE

    SIGNATURE OF APPLICANT RECEIVED BY

    PROCESSED BY
    DATE: MEMBERSHIP CODE

    The DXN International European Representation: DXN Europe Ltd.


    E-mail: office@dxneurope.eu Web: www.dxneurope.eu

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