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BORANG PENDAFTARAN AGENT FARM FRESH

AREA: NO.
DEALER :
STATUS: FULL TIME / PART TIME
TARIKH BERMULA:

DETAIL PERIBADI

NAMA:___________________________________________________________

MYKAD NO:___________________________________
UMUR:____________________________

ALAMAT:_________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

JANTINA: LELAKI / PEREMPUAN PEKERJAAN:_______________________

ALAMAT PEKERJAAN:_______________________________________________________________

_________________________________________________________________________________

STATUS : BUJANG/BERKAHWIN ANAK:____________________________

NO.TELEFON : (H/P)___________________ (H):_____________________ EMAIL:_______________

NAMA SOSIAL MEDIA: (FB)___________________________________________________________

(IG)___________________________________________________________

DAERAH:__________________________________________________________________________

KAWASAN PERNIAGAAN :____________________________________________________________

____________________________________________________________

____________________________________________________________

JENIS PERNIAGAAN : PASAR/CAR BOOTH/DELIVERY/KEDAI/SEKOLAH/BORONG/PETROL PUMP

ASET TERSEDIA:_____________________________________________________________________

KENDERAAN TERSEDIA:______________________________________________________________

AVERAGE SALES SEBULAN:____________________________________________________________

TANDATANGAN PEMOHON DITERIMA OLEH :

_______________________ ______________________

NAMA: NAME:

MYKAD NO: MYKAD NO:

TARIKH : TARIKH:

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