YAN LI BAO MEMBER REGISTRATION FORM
*Name :
*I/C Number :
* Example : 900825-08-XXXX
 Date of Birth :
 Gender : Male Female
 Race
:    
 Martial Status
:
 Mailing Address
:
 Postcode
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 City
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 State
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*Contact No(Mobile)
:
 Contact No(Home)
:
 Email Address
:
 Occupation
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*Where did you hear about Us?
:    
 
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