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APLIKASI MEMBER ONLINE
Dengan mengisi Form Registrasi Member Promo dibawah ini, maka anda setuju dan terikat pada keanggotaan River-X Spa
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Nama Lengkap
Your answer
Nama Pada Kartu Anggota
Your answer
Nomor Telepon Yang Dapat Di Hubungi
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Alamat Email
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Alamat Lengkap
Your answer
Jenis Kelamin
Laki-laki
Perempuan
Tanggal Registrasi Keanggotaan
MM
/
DD
/
YYYY
Jenis Kartu Anggota
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Member Silver
Member Gold
Pilihan Pemberitahuan Setelah Kartu selesai Di Prosses
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Di Hubungi Via SMS
Di Hubungi Via Email
Di Hubungi Via Telepon
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