Registration Form   Note : 1. Normal Membership Fees :     Singapore :  RM200 (Sign-up) + RM200 (Cash Advance) = RM 400   2. All sign-up fees must be fully paid before activation of membership.   Please complete the registration form. Areas marked * are required fields     Personal Information 1 Name * 2 Gender* Male Female 3 Date of birth* -- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / -- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / ---- 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 4 NRIC*   5 Race Please select race Chinese Malay Indian Others 6 How will you use EXCARD's printing services* For Reselling Purpose For Company Usage Please indicate line of work Commercial Printing Print Brokering (Runner) Advertising & Promotions Graphic Designing Please indicate company type Small Office - Home Office (SOHO) Corporate 7 Job Description 8 How do you know Excard* Please select Road Side Banner Flyer Newspaper Friends Post Card Search Engine Direct Mailer Email Magazine Mobile Money Exhibition 9 Name of Company 10 Company Registration No. Contact Information 11 Tel * 12 Fax 13 Mobile Phone 14 E-mail * 15 Re-enter Email * Please make sure the e-mail you have entered is valid. This is the email address which we will use to communicate with you.
16	Shipping Address *(Line 1)
	(Line 2)
17	Postcode *
18	Town *
19	Country	Singapore
Login Information
Please choose a username & a password you can easily remember
20	User Name *
21	Password *

22	Password again *