Kitamen Akses Kad Registration Form
To Be Filled By Person / Outlets / Agents in Charge Handing Out the Cards.

To be used if the members are collecting the physical cards only at later stage

Email address *
AKSES CARD NUMBER *
Your answer
NAME AS PER IC *
Your answer
IC NUMBER *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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